St. Louis offers innovative cerebral palsy surgery

ST. LOUIS (AP) - Parents from around the world are bringing children with cerebral palsy to St. Louis, where a neurosurgeon has refined an operation that allows the children to walk.

The procedure known as selective dorsal rhizotomy was developed in the 1980s and involves cutting sensory nerves in the bottom of the spine to permanently relieve muscle spasticity caused by cerebral palsy.

The St. Louis Post-Dispatch (http://bit.ly/mUCQEl) reports that St. Louis Children's Hospital neurosurgeon T.S. Park has refined and studied the procedure more extensively than any other surgeon. Now, doctors worldwide are seeking to learn his technique, and he is increasingly treating children from around the globe.

Among those children are 6-year-old twins from Scotland, both of whom had the surgery two weeks ago. Isobel Finlayson said that when she took her children to physical therapy, she met several families who had made the trip to St. Louis to see Park.

Those stories, along with similar stories she found on Facebook, led Finlayson to bring the twins to see Park. The children have spent most of their lives in wheelchairs. Ellie wants to skip, while Laurie wants to play soccer.

"As a parent, it's my job to give them the best chance in life," Finlayson said. Her family was joined that week by nine other families from the United Kingdom, plus families from Austria, Italy, Korea, Mexico, Poland, Saudi Arabia and Singapore.

Seattle Children's Hospital pediatric neurosurgeon Samuel Browd counts himself among a new generation of neurosurgeons copying Park's technique. Browd's hospital began routinely offering selective dorsal rhizotomy about 18 months ago.

"We all certainly look to his publications for guidance on how the procedure is performed, and we are taking his lead when offering the procedure at our institution," Browd said. "He's really done a lot to advance this procedure, and that's allowed folks like myself to learn the technique from others he has taught, and bring it to communities like Seattle to serve the Pacific Northwest."

Part of the reason for the international attention Park has received is a Facebook group with nearly 2,000 members. Parents also post videos of their children struggling with a walker before surgery, then running around the room afterward.

Most people with cerebral palsy have spasticity in their lower limbs that makes walking and sitting difficult and causes pain.

Park pioneered a less-invasive technique in 1991 that involved removing bone from one vertebrae to locate the spasticity-causing nerves.

It has only been in recent years that his technique has caught worldwide attention, sparked in part by two news stories in the United Kingdom in 2009 and the Facebook page created later that year. From a handful of international patients in 2008, Park is on pace to operate on 75 from overseas this year.

Most patients are between the ages of 2 and 6, Park said, but adults can have the surgery as well.

Park said his surgeries have had no major neurological complications. However, complications can include paralysis, incontinence and loss of sexual function.

He said results of the surgery vary depending on the patient's mobility before surgery.

"For those children who were able to walk with assistance, many of them can walk by themselves," he said. "Those who were in a wheelchair can walk with a walker or crutches."

The treatment can cost $40,000 or more. International families often work for months to raise the money to cover airfare, surgery, physical therapy and accommodations in St. Louis for four to six weeks.

Finlayson's family has been raising money since January by hosting walks, bike rides and a climb to the tallest mountain in Scotland. They even bagged groceries to raise money.

Six days after having the surgery, Ellie walked with a physical therapist holding her by the waist. Laurie sat on a bench a few feet from a small goal and kicked a soccer ball. It was the first time he'd done so on his own.

"I made 10 goals!" he cheered.

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Information from: St. Louis Post-Dispatch, http://www.stltoday.com

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