Not all people with spastic cerebral palsy benefit from SDR. For those under 18 years of age,<unk>  requires that they be: * At least 2 years of age * Diagnosis of moderately involved or higher levels of spastic diplegia, spastic quadriplegia or spastic hemiplegia * Some form of independent mobility; for example, crawling or walking with or without an assistive device * History of premature birth; if born at full term, child must have typical signs of spastic diplegia * No severe damage to the basal ganglia on MRI examination * Potential for improvement in functional skills For adults between 19 and 40 years of age,<unk>  requires: * Diagnosis of spastic diplegia * History of premature birth * Currently ambulates independently without assistive device * No fixed orthopedic deformities that either prevent current walking or would prevent walking after SDR; in these cases orthopedic releases are to be done first, after which SDR can be discussed. * Potential for functional gains after SDR * Intense motivation to attend intensive physical therapy and perform home exercise program On the limited number of adult spastic diplegic people treated with<unk> , satisfactory functional gains in adult patients are similar to those in children. As of 2014, the selection criteria used worldwide for choosing candidates for SDR were inconsistent, and only some measured the abilities of their candidates beforehand. Long-term effects The long-term effects of SDR are largely unknown. Selective dorsal<unk>  surgery has been performed routinely over the past several decades on children with spastic cerebral palsy, but there has been minimal evidence to support positive long-term outcomes. Required circumstances All candidates for<unk>  must have good muscle strength in the legs and trunk. There must also be evidence of adequate motor control, or the ability to make reciprocal movements for crawling or walking, and to move reasonably quickly from one posture to another. Chiefly, pediatric<unk>  candidates are people with CP who have shown age-appropriate progression in motor development, but spasticity hampers the development of skills and/or causes gait patterns like the scissors gait. In adults, the primary requirements are that the person is able to ambulate independently, but spasticity limits energy, flexibility, walking speed and balance and sometimes causes pain/muscle spasms.
Rhizotomy
Enterotomy
Iron preparation
Intravenous iron infusion
Chelation therapy
Activated charcoal cleanse
Bloodletting
Gastroduodenostomy