Above the hips, persons with spastic diplegia typically retain normal or near-normal muscle tone and range of motion, though some lesser spasticity may also affect the upper body, such as the trunk and arms, depending on the severity of the condition in the individual ( the spasticity condition affecting the whole body equally, rather than just the legs, is spastic quadriplegia, a slightly different classification ).
42.
Dorsal rhizotomy or selective dorsal rhizotomy ( SDR ), less often referred to as selective posterior rhizotomy ( SPR ), is the most widely used form of rhizotomy, and is today a primary treatment for spastic diplegia, said to be best done in the youngest years before bone / joint deformities from the pull of spasticity take place, but it can be performed safely and effectively on adults as well.
43.
Differential diagnosis of HSP should also exclude spastic diplegia which presents with nearly identical day-to-day effects and even is treatable with similar medicines such as baclofen and orthopedic surgery; at times, these two conditions may look and feel so similar that the only " perceived " difference may be HSP's hereditary nature versus the explicitly non-hereditary nature of spastic diplegia ( however, unlike spastic diplegia and other forms of spastic cerebral palsy, HSP cannot be reliably treated with selective dorsal rhizotomy ).
44.
Differential diagnosis of HSP should also exclude spastic diplegia which presents with nearly identical day-to-day effects and even is treatable with similar medicines such as baclofen and orthopedic surgery; at times, these two conditions may look and feel so similar that the only " perceived " difference may be HSP's hereditary nature versus the explicitly non-hereditary nature of spastic diplegia ( however, unlike spastic diplegia and other forms of spastic cerebral palsy, HSP cannot be reliably treated with selective dorsal rhizotomy ).
45.
Differential diagnosis of HSP should also exclude spastic diplegia which presents with nearly identical day-to-day effects and even is treatable with similar medicines such as baclofen and orthopedic surgery; at times, these two conditions may look and feel so similar that the only " perceived " difference may be HSP's hereditary nature versus the explicitly non-hereditary nature of spastic diplegia ( however, unlike spastic diplegia and other forms of spastic cerebral palsy, HSP cannot be reliably treated with selective dorsal rhizotomy ).
46.
In September 2008, a SDR was performed that'closed the gap'on concerns regarding age of the patient in SDR : Children's Hospital's Richard C . E . Anderson performed an SDR surgery on a 28-year-old male with " moderate " spastic diplegia, which by the patient's own report has reduced his muscle tone nearly to the level of a " normal " person and enabled him to walk and exercise much more efficiently; also, Dr . Anderson in the past performed an SDR on a 16-year-old wheelchair-using female with " severe " spastic diplegia.
47.
In September 2008, a SDR was performed that'closed the gap'on concerns regarding age of the patient in SDR : Children's Hospital's Richard C . E . Anderson performed an SDR surgery on a 28-year-old male with " moderate " spastic diplegia, which by the patient's own report has reduced his muscle tone nearly to the level of a " normal " person and enabled him to walk and exercise much more efficiently; also, Dr . Anderson in the past performed an SDR on a 16-year-old wheelchair-using female with " severe " spastic diplegia.
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