User:Hoodryan24/sandbox

Article Evaluation

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  • There is one discussion happening on the Talk page that is discussing where citations are needed, where grammatical errors are and that the article is biased towards the rhizotomy being the best treatments with no negative effects or possible problems that can arise.
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User:Halestorm18/sandbox User:AlexLamphear/sandbox

Week 4:

I think some information about what age ranges benefit the most from the surgical intervention should be reinforced in the article, as of which I have stated below. I also believe that information regarding long term benefits of the surgical intervention should be added to make people aware of the functional potential these children may achieve as they enter adulthood, which I have also listed below.

"SDR yields durable reduction in spasticity after 10 years. Early improvements in motor function are present, but at long-term follow-up, these improvements were attenuated in GMFCS II and III and were not sustained in GMFCS IV and V."

Ailon, T., Beauchamp, R., Miller, S., Mortenson, P., Kerr, J., Hengel, A., & Steinbok, P. (2015). Long-term outcome after selective dorsal rhizotomy in children with spastic cerebral palsy. Child's Nervous System, 31(3), 415-423. doi:10.1007/s00381-015-2614-9

"DR are between 4 and 7 years old and have a preoperative GMFM between 65% and 85%."

Funk, J. F., Panthen, A., Bakir, M. S., Gruschke, F., Sarpong, A., Wagner, C., & ... Haberl, E. J. (2015). Predictors for the benefit of selective dorsal rhizotomy. Research In Developmental Disabilities, 37127-134. doi:10.1016/j.ridd.2014.11.012

"Two of the classic studies of the efficacy of SDR5,6 were limited to children below 7 years old and showed improvement in gross motor function whereas a third study7 which extended to 18 years showed only mar- ginal improvement. The current study by MacWilliams et al. would appear to confirm that SDR is generally in- appropriate in later childhood and adolescence when other factors are more important than spasticity."

Baker, R., & Graham, K. (2011). Functional decline in children undergoing selective dorsal rhizotomy after age 10. Developmental Medicine & Child Neurology, 53(8), 677. doi:10.1111/j.1469-8749.2011.04020.x

Week 5: I feel that the author jumps from topic to topic without any leading or ending sentences to tie in the previous or following paragraphs. The information regarding facet rhizotomy should not be in the introductory paragraph, but maybe later on to explain the differences. Put a lot of the information in layman' terms to make it easier to read. Should include the ICD-10 code instead of the ICD-9 so its acturate and updated information.

I wasn't able to find anything that you guys have really written for your article in your sandboxes, so I figured I would provide my input about your article. I think it could really be beefed up in the post-surgical sections, which is great because that is where PT is going to be especially important. Providing a full protocol and prognosis would be very informative for the patient. It looks like you guys have a lot of good sources, so incorporating those would be ideal. It also looked like a lot of the stuff in the article needs references. It may also benefit from pictures to more clearly explain the procedure and make it more visually appealing to the readers. Otherwise, the article appears to have a good start. Kolby Arnold (talk) 16:14, 11 October 2017 (UTC)Kolby Arnold

Week 6:

A rhizotomy is a term chiefly referring to a neurosurgical procedure that selectively destroys problematic nerve roots in the spinal cord, most often to relieve the symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy.[3] The selective dorsal rhizotomy (SDR) for spastic cerebral palsy has been the main use of rhizotomy for neurosurgeons specialising in spastic CP since the 1980s; in this surgery, the spasticity-causing nerves are isolated and then targeted and destroyed. The sensory nerve roots, where spasticity is located, are first separated from the motor ones, and the nerve fibres to be cut are then identified via electromyographic stimulation. The ones producing spasticity are then selectively lesioned with tiny electrical pulses.

Rhizotomy In spasticity, rhizotomy precisely targets and destroys the damaged nerves that don’t receive gamma amino butyric acid, which is the core problem for people with spastic cerebral palsy. These over-firing, non-GABA-absorbing nerves generate unusual electrical activity during the EMG testing phase in SDR and are thus considered to be the source of the patient's hypertonia; they are eliminated with the electrical pulses once identified, while the remaining nerves and nerve routes carrying the correct messages remain fully intact and untouched. This means that the spasticity is permanently dissolved, and that this is done without affecting nervous system sensitivity or function in other areas, because the only nerves destroyed are the over-firing ones responsible for the muscle tightness.

The terms rhizotomy and neurotomy are also increasingly becoming interchangeable in the treatment of chronic back pain from degenerative disc disease. This is a procedure called a facet rhizotomy[4] and is not a surgical procedure but is instead done on an outpatient basis using a simple probe to apply radiofrequency waves to the impinged pain-causing nerve root lying between the facet joint and the vertebral body. Such radio frequency nerve lesioning results in five to eight or more months of pain relief before the nerve regenerates and another round of the procedure needs to be performed.[5] A facet rhizotomy is just one of many different forms of radiofrequency ablation, and its use of the "rhizotomy" name should not be confused with the SDR procedure.

EDIT OF INTRO: A rhizotomy is a term referring to a neurosurgical procedure that selectively destroys problematic nerve roots in the spinal cord, most often to relieve the symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy to increase their function. The selective dorsal rhizotomy (SDR) for spastic cerebral palsy has been the main use of rhizotomy for neurosurgeons specialising in spastic CP since the 1980s. Previous to this treatment, spasticity was mostly treated by oral and intravenous medications of baclophen and botulinum toxin accompanied with tendon lengthening and electrical stimulation.

Rhizotomy In spasticity, rhizotomy precisely targets and destroys the damaged nerves that don’t receive gamma amino butyric acid, which is the core problem for people with spastic cerebral palsy. These over-firing, non-GABA-absorbing nerves generate unusual electrical activity during the EMG testing phase in SDR and are thus considered to be the source of the patient's hypertonia. Once the nerves are eliminated with the electrical pulses, the remaining nerves and nerve routes carrying the correct messages remain fully intact and untouched. This reduces messages from the affected muscle, which will result in a better balance of activity to and from the nerve cells in the spinal cord to reduce spasticity.

Other Types of Rhizotomy Foerster-Dandy's rhizotomy Sacrococcygeal rhizotomy bilateral sacral rhizotomy The terms rhizotomy and neurotomy are also increasingly becoming interchangeable in the treatment of chronic back pain from degenerative disc disease. This is a procedure called a facet rhizotomy[4] and is not a surgical procedure but is instead done on an outpatient basis using a simple probe to apply radiofrequency waves to the impinged pain-causing nerve root lying between the facet joint and the vertebral body. Such radio frequency nerve lesioning results in five to eight or more months of pain relief before the nerve regenerates and another round of the procedure needs to be performed.[5] A facet rhizotomy is just one of many different forms of radiofrequency ablation, and its use of the "rhizotomy" name should not be confused with the SDR procedure.