Surgeons Detail Single-Level Rhizotomy Technique for Pediatric Spasticity

Neurosurgeons in France have published a detailed operative description of a single-level selective dorsal rhizotomy technique for treating spasticity in children, outlining a method that accesses the entire lumbosacral nerve root supply through one limited opening in the spine. The article, published in Acta Neurochirurgica as an open-access “How I do it” paper, comes from Guillaume Dannhoff, Mona Boussif, Anaïs Chivet and Pia Vayssière.

Selective dorsal rhizotomy is an established surgical treatment for non-progressive spasticity, such as that seen in cerebral palsy, but the authors note that practice varies considerably between centers.

This single exposure allows intraoperative neurophysiological monitoring and electrical testing of the sensory nerve roots from the T12 thoracic level down to the S2 sacral level.

The approach also incorporates an individualized decision at the S2 level, where the surgeon chooses between sectioning or preserving the root depending on the patient’s specific pattern of spasticity.

In their conclusion, the authors report that the technique achieves permanent reduction of spasticity with no neurological morbidity in their described practice. As a technique-focused “How I do it” article, the paper presents the operative method and the authors’ experience rather than the results of a comparative trial, and the published version is an early-access, peer-reviewed accepted manuscript that may still undergo editorial changes before the final version of record. The full open-access article provides the step-by-step operative detail intended for centers performing or considering this procedure for children with spasticity.

Subject of Research: A surgical technique description for single-level selective dorsal rhizotomy with intraoperative neurophysiological monitoring in children with spasticity.

Article Title: How I do it: single-level selective dorsal rhizotomy with intraoperative neurophysiological monitoring from T12/L1 to S2 for pediatric spasticity

Article References: Dannhoff, G., Boussif, M., Chivet, A., & Vayssière, P. (2026). How I do it: single-level selective dorsal rhizotomy with intraoperative neurophysiological monitoring from T12/L1 to S2 for pediatric spasticity. Acta Neurochirurgica. https://doi.org/10.1007/s00701-026-07062-4

Image Credits: AI Generated

DOI: 10.1007/s00701-026-07062-4

Keywords: selective dorsal rhizotomy, pediatric spasticity, cerebral palsy, intraoperative neurophysiological monitoring, laminoplasty, conus medullaris, lumbosacral nerve roots, neurosurgery, Acta Neurochirurgica, surgical technique, single-level, selective