Maltese neurosurgeon Kristian Aquilina has introduced a life-changing procedure at London’s Great Ormond Street Hospital that will help children with cerebral palsy walk more easily and reduce painful muscle spasms.
Selective dorsal rhizotomy (SDR) involves cutting nerves in the lower spine that are responsible for muscle rigidity.
It is less invasive than alternative techniques
Each nerve root is electrically stimulated and the responses from these roots identify those nerves contributing to the muscle stiffness.
This process informs the surgeon which nerves to cut.
It is less invasive than other techniques and is suitable for children as young as three years old.
Mr Aquilina was the first to introduce the minimally invasive procedure to the UK when he performed it in the North Bristol NHS Trust in 2011, where he previously acted as a consultant.
Mr Aquilina graduated as an MD from the University of Malta in 1995 and continued his neurosurgical training in the UK.
He then completed a one-year clinical fellowship in paediatric neurosurgery in the US, spending time at the Centre for Cerebral Palsy in St Louis, Missouri, where SDR was first developed.
Mr Aquilina told Times of Malta that the benefits of this procedure include the children’s quicker return to physiotherapy, the reduced risk of long-term spinal complications and also its potential use for children who are severely affected by cerebral palsy.
The service at Great Ormond Street was set up over the past nine months.
Eight-year-old Niamh Horton, from Dundee, Scotland, was the hospital’s first patient.
After surgery, children would require a programme of physiotherapy – although they tend to recover from surgery within a few weeks, it may take them up to two years to derive the full benefits of the procedure.
“The surgery has already proven to significantly reduce muscle stiffness and give children the ability to stand and walk independently for the first time.
“The impact on their quality of life and that of their families is therefore enormous.”
What is it?
Cerebral palsy (CP) is a disorder that affects muscle control and coordination so that even simple movements – like standing still – are difficult.
Other vital functions that also involve motor skills and muscles, such as breathing, bladder and bowel control, and eating, may also be affected.
It does not get worse over time. CP is usually caused by brain damage that occurs before or during a child’s birth, or during the first three to five years of life.
This brain damage can also cause other health issues, including vision, hearing and speech problems, and learning disabilities. There is no cure, but treatment, therapy, special equipment, and, in some cases, surgery can help a child who is living with the condition.