NHS England has today (17 July) announced it will commission specialist surgery for a number of children with cerebral palsy who have difficulty walking, which could improve their mobility and level of independence.

Around 120 children a year could benefit from a procedure called Selective Dorsal Rhizotomy (SDR) as part of NHS England’s innovative Commissioning through Evaluation (CtE) programme .

Taking place at five hospitals across the country, the programme aims to gather vital evidence on the effectiveness of the procedure. Children aged between three and 10 who suffer stiffness in their lower limbs, and meet the clinical criteria for treatment, can access SDR as part of the initiative.

Cerebral Palsy is a central nervous system condition that can cause spasticity, the clinical term for tight and stiff muscles, which can lead to difficulties in movement, balance and posture.

SDR is an extremely complex and specialist procedure which involves opening up the bones of the spine in the lower back to operate on the nerves, which could potentially help relieve spasticity. The NHS does not routinely fund SDR for the condition because, although it is a promising treatment, current evidence on its effectiveness in such cases is limited.

NHS England has selected the following five Trusts across England to provide SDR as part of its Commissioning through Evaluation initiative:

• Alder Hey Children’s NHS Foundation Trust
• Great Ormond Street Hospitals NHS Foundation Trust
• Leeds Teaching Hospitals NHS Trust.
• Nottingham University Hospitals NHS Trust
• University Hospitals Bristol NHS Foundation Trust

SDR surgery will be carried out in clinically appropriate cases at these five centres. Children across England can be referred into one of these hospitals by their local specialists to be considered for treatment. The Trusts selected to provide the treatment gave evidence to an expert panel to demonstrate they had the expertise, skills and capacity to provide SDR, and that surgeons were already operating on at least 10 children a year.

James Palmer, Clinical Director of Specialised Services at NHS England, said: “For children with cerebral palsy, being unable to walk easily can be extremely distressing and painful. Although current evidence is limited, SDR surgery shows real promise for some patients with mobility problems and that’s why we want to explore it further through our innovative evaluation programme. Not only will this enable a number of children to have potentially life-changing surgery, improving their mobility and independence, but this provides a real opportunity to gather the vital evidence we need on the effectiveness of the procedure, for the benefit of our patients.”

NHS England will ensure all relevant specialists across the country are aware of the CtE programme so they can advise patients appropriately. Patients and their families who would like more information are encouraged to discuss options with their existing lead consultant.