Eber Medical Group
★ World First: FSPR for Paralyzed Hand — Dr. Sun Chenyan (2016)

FSPR — Functional Selective Posterior Rhizotomy

A precision neurosurgical procedure for reducing spasticity in cerebral palsy, hemiplegia, and paraplegia. Pioneered and continuously refined by Dr. Sun Chenyan at Eber Medical Group — including the first-in-world FSPR for a paralyzed hand.

What is FSPR?

FSPR — Functional Selective Posterior Rhizotomy — is a neurosurgical procedure that permanently reduces limb spasticity by selectively sectioning the overactive dorsal nerve rootlets in the spinal cord. Unlike drug treatments (e.g., baclofen, botulinum toxin), FSPR provides permanent spasticity reduction without ongoing medication.

The procedure was first adapted to clinical practice in China by Dr. Sun Chenyan at Eber Medical Group. In 2016, Dr. Sun performed the first-in-world FSPR for a paralyzed hand — a landmark extension of the technique to upper-limb spasticity. After surgery, patients who previously had a non-functional, contracted hand regained the ability to perform fine motor tasks: cutting vegetables, tying shoelaces, and brewing tea.

Indications for FSPR

  • Spastic cerebral palsy (CP) — lower and upper limb spasticity; from 6 months of age
  • Hemiplegia with limb spasticity (post-stroke, trauma, CP)
  • Paraplegia with lower limb spasticity (spinal cord injury, spina bifida)
  • Paralyzed hand with spasticity — Eber's unique indication (world first)
  • Equinus foot, scissor gait, clenched fist deformity

FSPR Procedure Steps

  1. Preoperative EMG Mapping: Identifies overactive nerve rootlets; determines surgical targets at specific spinal levels (L1–S2 for lower limbs; C5–T1 for upper limbs)
  2. General Anesthesia: Total intravenous anesthesia (TIVA) — avoids neuromuscular blocking agents to preserve IONM accuracy
  3. Intraoperative Neurophysiological Monitoring (IONM): Continuous EMG, MEP, and SEP monitoring throughout surgery under Carl Zeiss surgical microscope
  4. Laminectomy: Minimal laminectomy at target spinal levels — nerve rootlets are exposed
  5. Selective Stimulation & Sectioning: Each rootlet is stimulated individually at 50Hz; rootlets producing abnormal spread responses are selectively sectioned
  6. Closure & Recovery: Standard closure; patient wakes in Neuro-ICU; early rehabilitation begins within 48 hours

Rehabilitation After FSPR

Rehabilitation is integral to FSPR outcomes — surgery removes the spasticity barrier, but neuroplasticity and function are rebuilt through structured therapy:

Phase Duration Focus
Acute (Inpatient) Weeks 1–4 Wound care, early passive/active ROM, sensory re-education, bladder function
Sub-acute Rehabilitation Months 1–3 Muscle strengthening, gait training, occupational therapy, TMS, acupuncture
Active Rehabilitation Months 3–6 Functional tasks (writing, walking, ADL), robotic therapy, sports, independence
Maintenance Ongoing Home exercise program, outpatient TCM, periodic reassessment

Outcomes: What Patients Achieve After FSPR

  • Significant, permanent reduction in limb spasticity (MAS score improvement)
  • Improved gait — children who previously walked with scissors gait walk normally
  • Hand function restoration — fine motor tasks previously impossible become achievable
  • Reduced need for oral spasticity medications (baclofen, tizanidine)
  • Improved quality of life and family caregiver burden

Spasticity Surgery Programs & Pricing

Eber Medical Group offers a comprehensive range of spasticity reduction and functional restoration surgeries. All procedures are performed under general anesthesia with intraoperative neurophysiological monitoring (IONM) and Carl Zeiss surgical microscope.

Procedure Chinese Name Cost (CNY)
FSPR — Functional Selective Posterior Rhizotomy 功能性选择性脊神经后根部分离断术 120,000
CFSPR — Cervical Selective Posterior Rhizotomy 颈段选择性脊神经后根切断术 120,000
CP-MMA — Cerebral Palsy Muscle Strength & Tone Adjustment 肌力肌张力调整术 120,000
CPS — Common Carotid Artery Extrafibrous Sympathetic Plexus Denervation 颈总动脉外膜交感神经网剥脱术 120,000

Note: Prices include surgery, anesthesia, intraoperative monitoring, and 4–7 days hospitalization. Postoperative rehabilitation (3–6 months) is not included and is billed separately.

Advanced Neuromodulation & Implantable Devices

Procedure Chinese Name Cost (CNY)
SCS — Spinal Cord Stimulation Surgery (including test procedure) 脊髓电刺激手术 (含测试) 400,000
ITB — Intrathecal Baclofen Pump Implantation (including test procedure) 巴氯芬泵植入术 (含测试) 300,000

SCS & ITB: Prices include device, surgical implantation, test procedure, programming, and hospitalization. Device lasts 5–10 years depending on settings.

Rehabilitation Programs (30 Days)

Traditional Chinese Rehabilitation

中医康复 (30 天)

150,000–200,000 CNY
  • ✓ Acupuncture (scalp, body, auricular)
  • ✓ Tuina (therapeutic massage)
  • ✓ Moxa therapy
  • ✓ Herbal medicine
  • ✓ TCM constitution assessment

Western Medical Rehabilitation

西医康复 (30 天) · Neuromodulation

150,000–200,000 CNY
  • ✓ Robotic rehabilitation (Lokomat)
  • ✓ TMS / rTMS neuromodulation
  • ✓ Physiotherapy (PT)
  • ✓ Occupational therapy (OT)
  • ✓ Speech & swallowing therapy

Rehabilitation programs: 30-day inpatient programs include accommodation, all therapy sessions, TCM/Western treatments, and physician consultations. Cost varies based on intensity and specific treatments required.

FSPR — Frequently Asked Questions

What conditions is FSPR used for?
FSPR — Functional Selective Posterior Rhizotomy — is used for spastic cerebral palsy (CP), hemiplegia, paraplegia, and spasticity from spinal cord injury. It is particularly effective for lower limb spasticity (scissor gait, equinus foot) and, uniquely at Eber, for upper limb/hand spasticity — Dr. Sun Chenyan performed the first-in-world FSPR for a paralyzed hand in 2016.
How does FSPR differ from conventional SDR (Selective Dorsal Rhizotomy)?
FSPR (Functional Selective Posterior Rhizotomy) is a more refined, function-preserving version of SDR. It targets only rootlets causing pathological spasticity while preserving sensory function — verified by intraoperative neurophysiological monitoring (IONM). Eber's technique, developed by Dr. Sun Chenyan, also extends the indication to upper-limb spasticity (first-in-world for paralyzed hand, 2016).
What results can patients expect after FSPR?
For lower limbs: significant reduction of spasticity, improved gait pattern, better walking speed and endurance. For upper limbs/hand (Eber's innovation): patients regain fine motor function — cutting vegetables, tying shoelaces, writing, brewing tea. Combined with 3–6 months of rehabilitation, most patients achieve functional independence milestones.
What is the recovery timeline after FSPR?
Week 1–4: Inpatient rehabilitation, wound care, early physiotherapy. Months 1–3: Intensive outpatient/inpatient rehab, muscle strengthening, gait training, occupational therapy. Months 3–6: Progressive functional rehabilitation; most improvement achieved. TCM (acupuncture, tuina) is integrated throughout the rehabilitation phase.
Is FSPR safe for young children?
Yes. FSPR is performed at Eber Medical Group in children from 6 months of age under general anesthesia with continuous intraoperative monitoring. The safety profile is well-established; the most significant risks are temporary sensory changes and urinary retention, both managed proactively in our ICU-equipped facility.