Hi all,
Sorry, not been around much, too much physio!
To clear up a few points. The Oswestry version of SDR is the older one, it is more invasive, leaves a bigger scar and does not go down so far, this means it is at less risk of causing bladder, bowel and sexual function problems. However even Mr. Roberts, the surgeon, thinks this is a theoretical risk but it's one he doesn't want to take. This means that the Oswestry version of SDR leaves residual spasticity in the calves. As a result of this it is a more conservative procedure, not only does it not include so many vertibrae, mr Roberts only cuts between 30 and 40 percent of the nerves.
The USA / Bristol SDR is the same operation, the Bristol dr trained with the American dr. This is a more radical op, as usually at least 50 percent of the nerves are cut and more of the nerves are chosen, ie the ones from the lower regions are included as well. This is where the possibility of bladder/ bowel issues comes from but as I said earlier it's unlikely anyway to cause a problem. The op is done in a different way, more like keyhole surgery, so the scar is smaller and the time spent lying flat on your back less post op. I think it's 48 hours compared to 5 days in Oswesrty.
The biggest difference though is in the selection procedure for the op. Oswestry will only take those who they know will show a significant, measurable, benefit, usually a move from GMFCS 3 to 2 or from 2 to 1. This is partly due to the funding issues of the NhS and partly due to Mr Roberts belief that post op is too much work for those who will only see a minor improvement as they are already too able or those who are too severe will not be able to do enough effective physio.
Dr Park and Dr aquilina have much broader criteria as for them the removal of spasticity may allow walking, even if not independent, which brings a great improvement in the outcome of the child receiving the op.
Here I feel I need to say, we chose the Oswestry version for a number of reasons but nearly went to America. I have previously been attacked (subtly but obviously) for our choices but in my eyes we are all doing the best for our children and I have no critisim about any of the surgeons, they are all offering a freedom to our children they would not otherwise have. Mr. Roberts does not deserve the vitriol I see in some parts of the SDR community but neither does Mr park deserve the label that he's only in it for the cash that I also see.
Having got that out of the way! I would encourage anyone interested to look at all options. It certainly has been life changing for DS and all of us, but it is very, very hard work for him and the whole family and that is not to be underestimated.
Will now look at the rest of the thread, once both DSes are in bed, I think this post inquire long enough!