Selective Posterior Rhizotomy: Evolution of Theory and Practice

The spastic type of cerebral palsy has become more prevalent due to improved survival rates of premature infants. Selective posterior rhizotomy is a neurosurgical procedure which is designed to reduce spasticity and has been successfully used for children with spastic cerebral palsy. Although the procedure of posterior rhizotomy is nearly 100 years old, a revised technique was introduced in 1981. Since that time, the procedure has been further refined and its use has altered the theory and practice of cerebral palsy management. This paper reviews the neurophysiological and anatomical facts that have influenced the development of the technique. The current practice of selective posterior rhizotomy is an evolving process which has stimulated scientific interest in spasticity, cerebral palsy and its management.