In 1987 at the University of Virginia, pediatric neurosurgeon T.S. Park, MD, sought to decrease the cerebral palsy spasticity of 5-year-old Sara Kate. He performed a new and somewhat controversial procedure that made her more comfortable and enabled her mother to better manage her care. Dr. Park, the chief of pediatric neurosurgery at St. Louis Children's Hospital for the past decade, has performed more than 1,000 selective dorsal rhizotomies and is considered a pioneer in its use.
Thanks in part to Dr. Park's work, children with cerebral palsy have a chance to live active, more normal lives. Children with cerebral palsy have motor impairments affecting their coordination and spasticity that causes stiffness in the muscles of their arms, legs and trunk. This spasticity often interferes with movement, achievement of motor milestones and the development of walking. When left untreated, the stiffness can cause spine and limb deformities.
His own laboratory research into newborn brain injury fueled Dr. Park's interest in selective dorsal rhizotomy, which he became convinced could decrease spasticity in many of the 750,000 cerebral palsy patients in this country.
For reasons that are still unclear, the brain of a child with cerebral palsy is unable to influence the amount of flexibility a muscle should have. By operating on the sensory nerve fibers that come from the muscle of the leg, Dr. Park can better balance their dominating messages with the messages of flexibility from the brain. Once the muscle tone becomes more normal, it is easier for the child to move and gain the motor skills needed to sit, crawl, stand and walk.
In the 10 years since he started performing the procedure, Dr. Park has made improvements that have helped earn him the reputation of being one of the nation's premier pediatric neurosurgeons. For example in 1991, Dr. Park developed a surgical modification that requires a limited removal of the vertebrae for dorsal rhizotomy. According to Dr. Park, these improvements made it possible for dorsal rhizotomy to be performed on older children as well as adults.
"Since my dorsal rhizotomy, I have learned to simply roll over in bed without using every muscle in my body," writes Leigh, a 23-year-old patient of Dr. Park. "I can finally climb in and out of cars easily and get in and out of the bathtub. In the past, I felt as if my legs really weren't part of my body. But now, for the first time in my life, I feel almost graceful."
"We are probably the only cerebral palsy spasticity center in the country to offer dorsal rhizotomy to adolescents and adults," Dr. Park says. "We will continue to develop ways to broaden the number of patients who can benefit from the surgery."
With his dedication to making life better for his patients and a recently awarded $1.8 million National Institutes of Health grant to his team for study of the surgery, Dr. Park's thousandth dorsal rhizotomy should not be long in coming.
