Start-Up of Rhizotomy Program in a Developing Country.

The selective dorsal rhizotomy (SDR) procedure is an efficient surgical treatment of spasticity in children with cerebral palsy. My training background of pediatric neurosurgery at the British Columbia's Children's Hospital, an experienced center for spasticity, allowed me to contribute to the start-up of the rhizotomy program in Ulaanbaatar, Mongolia, in September 2022. Five spastic children with cerebral palsy with GMFCS levels 2-4 were chosen for the first SDR procedures. Intensive physiotherapy and rehabilitation program were given to children after SDR. After 6 months, early results were satisfactory.My personal experience of performing first SDR surgeries in another country is that the minimum of a SDR surgery team consists of a neurosurgeon, an electrophysiology technician responsible for selection of nerve rootlets, and an anesthesiologist. The physiotherapist responsible for patient selection and rehabilitation follow-up and rehabilitation facilities and family support are essential.