Selective Dorsal Rhizotomy Surgery Cost in Turkey

If conservative treatments for cerebral palsy (CP), such as braces and oral medications, do not provide sufficient relief, your doctor may consider the option of neurosurgery.

One possible procedure is selective dorsal rhizotomy (SDR), which can improve mobility in many children suffering from spasticity along with dystonia, a condition marked by increased muscle stiffness and spasms.

Selective Dorsal Rhizotomy Surgery Cost in Turkey

Selective Dorsal Rhizotomy Surgery Cost in Turkey starts from 3000 USD to and can go up to 7500 USD, furthermore, the exact can vary depending on the location, the hospital, or according to the patient’s condition.

Selective Dorsal Rhizotomy Surgery Cost in Different Cities in Turkey

Factors That Can Affect Selective Dorsal Rhizotomy Surgery Cost in Turkey

There are several factors that can impact the cost of selective dorsal rhizotomy surgery cost in Turkey. Below is the list of it: 

Hospital and Facility Fees: The selection of a hospital or medical facility significantly affects the overall expenses. Prestigious hospitals equipped with cutting-edge technology and high success rates tend to impose higher charges.

Surgeon’s Skill and Standing: The qualifications and reputation of the neurosurgeon conducting the operation can influence the total cost. Surgeons with extensive experience and specialized skills may command higher fees for consultations and surgeries.

Pre-Operative Evaluations and Tests: Thorough pre-surgical evaluations, including MRI, CT scans, and neurological examinations, are essential for assessing the patient’s condition. The costs associated with these evaluations can contribute to the overall financial burden.

Anesthesia Type and Surgery Length: The choice of anesthesia and the length of the surgical procedure can affect the total expenses. More prolonged or intricate surgeries may lead to increased costs for anesthesia and operating room usage.

Post-operative Rehabilitation and Therapy: SDR surgery necessitates rigorous post-surgical physiotherapy and rehabilitation to enhance mobility and functionality. The extent and duration of rehabilitation can influence the final costs.

Duration of Hospital Stay and Level of Care: The length of the hospital stay following surgery, along with the type of care received (ICU, general ward, or private room), can significantly impact the total costs incurred.

Complications and Follow-Up Treatment: Any complications arising post-surgery or the need for additional follow-up appointments may elevate costs, depending on the required level of care after the procedure.

Hospital Location in Turkey: The city where the surgery is conducted, such as Istanbul, Ankara, or Izmir, can affect pricing due to variations in operational costs and living expenses.

What is Selective Dorsal Rhizotomy?

Selective Dorsal Rhizotomy (SDR) is a surgical procedure aimed at reducing spasticity in the lower limbs.

Spasticity results from disrupted communication between the brain and the nervous system. SDR effectively mitigates this issue by cutting the nerve rootlets in the spinal canal that send abnormal signals to the muscles.

Cerebral palsy is the most common cause of spasticity in children. Although SDR does not cure cerebral palsy, it seeks to improve the quality of life and mobility for affected children.

Who Can Benefit From Selective Dorsal Rhizotomy Surgery?

Children undergo a comprehensive assessment to determine if Selective Dorsal Rhizotomy (SDR) is the appropriate treatment choice. The chances of benefiting from the surgery are greater for children who:

– primarily exhibit spasticity in their legs

– can walk independently or with the help of a walker or braces, or have the potential to do so

– are physically and mentally ready to participate in rigorous physical therapy after the surgery

– show motivation and the ability to follow instructions

On the other hand, SDR may be less effective for children with significant spasticity in their arms or those who need assistance to maintain an upright sitting position. It is recommended to discuss all available treatment options with your child’s neurosurgeon and cerebral palsy care team.

What Types of Diagnoses Are Conducted Before SDR Surgery?

Selective dorsal rhizotomy (SDR) is not a one-size-fits-all solution for every child with cerebral palsy. Therefore, a thorough screening process is essential to determine if your child is a suitable candidate for the procedure.

Your child will typically be assessed by a team of specialists, which may include:

• Pediatric neurosurgeon: This expert will evaluate your child’s lower limbs and the condition of their underlying muscles, drawing on their experience with SDR in pediatric patients.
• Pediatric orthopaedic surgeon: This specialist will assess whether any orthopedic interventions are necessary to address issues like bone deformities or contractures, which involve significant muscle stiffness.
• Physical therapist: This professional will evaluate your child’s levels of spasticity and the functionality of their leg muscles.
• Occupational therapist: This therapist will examine your child’s current and potential abilities in daily activities such as walking, eating, dressing, and playing.

After individual assessments by each team member, the group will come together to discuss the potential advantages of SDR.

Before the surgery, your child may need further evaluations, which could include:

• In-depth assessments by physical and occupational therapists to thoroughly evaluate your child’s physical abilities. They will document your child’s movements and daily activities, creating a rehabilitation plan for post-surgery recovery.
• A brain MRI to rule out any other neurological issues.
• A consultation with a pediatric neurologist to address any existing neurological conditions.
• A meeting with the pediatric neurosurgeon to discuss surgical risks and outline the recovery process.
• An appointment with an anesthesiologist to ensure the safety of general anesthesia for your child.

How is Selective Dorsal Rhizotomy Surgery is Conducted?  

The process of selective dorsal rhizotomy surgery typically includes the following steps:

• First, an anesthesiologist administers general anesthesia to the child, ensuring they are unconscious and free from pain throughout the procedure.  
• Next, the neurosurgeon makes a small incision in the center of the child’s lower back.  
• Through this incision, the surgeon creates a small “window” in the spine by carefully navigating through the muscle, bone, and the protective layer surrounding the spinal cord (dura) to reach the underlying nerve fibers.  
• The neurosurgeon then identifies and separates the motor nerves from the sensory nerves, ensuring the motor nerves are preserved during the procedure.  
• Electrodes are attached to the sensory nerve roots, and the surgeon uses electromyography (EMG) to stimulate the nerves, determining which ones are responsible for spasticity and which are functioning normally. Multiple stimulations are conducted to accurately identify the nerves that will be cut.  
• The surgeon then proceeds to sever a specific percentage of the abnormal sensory nerves, with the exact nerves and amount varying for each child.  
• Once the nerve sectioning is complete, the incision is closed in layers.  
• Finally, the healthcare team transfers the child to a recovery room, where they will be closely monitored during the recovery phase, often in the intensive care unit (ICU).  
• Children usually stay in the hospital for approximately five days following the surgery. During the first 24 to 48 hours, it is crucial for the child to remain in a flat position. Physical therapy will begin a few days after the surgery.

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