Cerebral Palsy FSPR Surgery: Case Study — Child Walks After Treatment at Eber Medical Group
By Eber Medical Group Editorial Team
Case Study: Spastic Diplegia CP — FSPR Surgery Restores Walking
Patient: Male, age 4 at time of surgery
Diagnosis: Spastic diplegia cerebral palsy (GMFCS Level III)
Hospital: Qingdao Yibo Hospital, Eber Medical Group
Surgeon: Dr. Sun Chenyan
Procedure: FSPR (Functional Selective Posterior Rhizotomy) + postoperative rehabilitation
Background
The patient presented with bilateral lower limb spasticity from birth asphyxia. At age 4, the child could stand with support but was unable to walk independently due to severe scissor gait and equinus foot positioning. Previous treatments included botulinum toxin injections and physiotherapy, which provided temporary but insufficient relief.
Modified Ashworth Scale (MAS): Grade 3 bilateral hip adductors, Grade 2+ knee flexors
GMFCS Level: III (walks with assistive device)
Goals: Independent ambulation, reduced tone, improved daily function
Diagnostic Workup at Eber Medical Group
| Method | Finding |
|---|---|
| Philips MRI 3.0T (brain) | Periventricular leukomalacia (PVL), bilateral |
| Video-EEG | Normal — no epileptiform activity |
| EMG / Gait Analysis | Overactive bilateral L2–S1 dorsal rootlets; scissor pattern confirmed |
| TCM Assessment | Kidney essence deficiency syndrome; recommended combined acupuncture |
| Neuropsy Testing | Cognitive development — 85th percentile for age |
Treatment: FSPR Surgery
Under general anesthesia with continuous intraoperative neurophysiological monitoring (IONM), Dr. Sun Chenyan performed FSPR at L2–S1 levels bilaterally under Carl Zeiss surgical microscope.
- Stimulation at 50Hz identified 60% of rootlets with abnormal spread patterns
- Selected rootlets sectioned; sensory rootlets preserved
- Surgery duration: 3.5 hours
- No intraoperative complications
Rehabilitation (Western Medicine + TCM)
Weeks 1–4 (Inpatient):
- Early passive range-of-motion exercises from Day 2
- Gradual weight-bearing by Week 2
- Acupuncture (Baihui, Zusanli, Xuanzhong, Jiexi) — 5 days/week
Months 1–3 (Intensive Rehab):
- Lokomat robotic gait training 5×/week
- Occupational therapy for ADL
- Tuina massage for lower limb circulation
- TMS (cortical stimulation) 3×/week
Months 3–6:
- Progressive ambulation training without assistive device
- Balance board, parallel bars → outdoor walking practice
Outcomes
| Measure | Pre-Surgery | 6 Months Post-FSPR |
|---|---|---|
| MAS Hip Adductors | Grade 3 | Grade 0–1 |
| MAS Knee Flexors | Grade 2+ | Grade 1 |
| GMFCS Level | III | I |
| Independent Walking | No | Yes (outdoors) |
| Scissor Gait | Severe | Absent |
The child now attends regular school and participates in physical education classes.
Key Takeaways
- FSPR from age 4 (Eber accepts patients from 6 months) provides optimal neuroplasticity window
- Integrated Western medicine + TCM rehabilitation accelerates functional recovery
- Outcome confirms Dr. Sun Chenyan’s technique: permanent spasticity reduction without ongoing medication
- Patient achieved GMFCS Level I — functional independence — within 6 months
This case study represents typical outcomes for spastic diplegia CP at GMFCS Level III. Individual results vary based on CP type, severity, age, and rehabilitation compliance. Contact Eber Medical Group for a personalized assessment.