Twenty-one studies (966 children; 945 children calculated from table 1) were included in the review. Three studies had a control group and were classed as level III evidence scoring 3, 4 or 5 out of 7 on the quality assessment. Eighteen studies were classed as level IV evidence (uncontrolled case studies). Study follow-up ranged from five to 21.4 years.
There was moderate evidence that selective dorsal rhizotomy had a positive effect on body function and body structure at five to 20 years follow-up (two level III studies with healthy controls). Five of six level IV evidence studies supported these findings.
One level III evidence study showed no improvement in gross motor function after selective dorsal rhizotomy and eight level IV studies showed mixed findings. There were no statistically significant differences in function between children undergoing selective dorsal rhizotomy versus children treated with intensified physical therapy alone (one level III study). Further findings from level IV were presented in the review.
Adverse events following selective dorsal rhizotomy were reported in six studies in between 2% and 56% of children and included scoliosis, kyphosis, lumbar lordosis, spondylolysis, grade I spondylolisthesis, back pain, spinal stenosis, disc protrusion and black discs.