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: Technical Excellence
At Eber Medical Group, FSPR is performed with a focus on bone-preserving surgery. Unlike traditional Selective Dorsal Rhizotomy (SDR) that often requires extensive bone removal, our technique utilizes Hemi-laminectomy or even procedures without bone resection.
- Bone-Preserving Access: Minimal incision and limited bone window to access the spinal canal. This preserves the structural integrity and stability of the growing child's spine.
- Intraoperative Neurophysiological Monitoring (IONM): Continuous 50Hz stimulation using Carl Zeiss surgical microscopes to identify pathological rootlets.
- Precision Sectioning: Only the overactive Ia-fibers are sectioned, effectively "cutting the noise" without losing sensation.
- Minimal Blood Loss: Advanced hemostatic technologies ensure the procedure is virtually bloodless.
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)
- ✓ Acupuncture (scalp, body, auricular)
- ✓ Tuina (therapeutic massage)
- ✓ Moxa therapy
- ✓ Herbal medicine
- ✓ TCM constitution assessment
Western Medical Rehabilitation
西医康复 (30 天) · Neuromodulation
- ✓ 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.