SDR Surgery Update: The First 24 Hours

Monday, June 1st, 2026, was a big day.

We arrived at Children’s Memorial Hermann bright and early at 5:30 AM on Monday, June 1st for Amri’s Selective Dorsal Rhizotomy (SDR) surgery.

For those who are new here, SDR is a neurosurgical procedure designed to reduce spasticity by identifying and cutting selected sensory nerve rootlets that send abnormal signals to the muscles. The goal isn’t to cure cerebral palsy, but rather to reduce spasticity and create new opportunities for mobility, strength building, and functional progress through intensive therapy. And in our case, hopefully reduce, or eliminate, the need for future surgeries and procedures down the road.

The morning was filled with all the usual pre-op procedures: vitals, paperwork, meeting with anesthesia, checking in with Dr. Shah, and spending time with Child Life. Everyone worked hard to make the morning as smooth as possible.

At 7:30 AM, Amri was given Versed to help with his severe separation anxiety. If you’ve met Amri, you know he likes to know exactly where Mom and Dad are at all times, so this was one of the parts we had been most worried about.

The team wheeled him back with his iPad, and shortly afterward Lauren from Child Life came out to update us. She told us that Amri did realize we weren’t there and became upset, but she held him and comforted him while the anesthesia team got him settled. They quickly administered the gas anesthesia, and he fell asleep safely.

From there, all we could do was wait. It was the longest 4 hours of our lives.

Thankfully, we received text updates throughout the surgery. The procedure began around 8:00 AM and finished around 11:50 AM.

After surgery, Dr. Shah met with us and shared that everything had gone well.

One thing that surprised us was learning that while the spasticity-causing nerves had been addressed, Amri’s muscles themselves remain extremely tight. Dr. Shah explained that muscles can stay shortened after years of abnormal muscle tone, even after the nerve signals causing the spasticity are reduced.

He told us he cut approximately 80% of the nerves contributing to the spasticity on Amri’s right side.

Because of the muscle tightness, he expects Amri will likely need serial casting during rehab. Serial casting involves applying a series of casts over time to gradually stretch tight muscles and improve range of motion.

He also mentioned another procedure called PERCS that is sometimes used when casting alone isn’t enough. In all of his years performing SDR surgery, only two of his patients have needed that additional procedure. Right now, we simply don’t know where Amri’s journey will fall. Our hope is that serial casting will do the trick, but only time will tell.

After surgery, Amri woke up in recovery exactly how many toddlers wake up from anesthesia: emotional, confused, angry, and not at all happy about the situation.

About an hour later, we were transferred to our room.

The next challenge began immediately.

For the first 24 hours following SDR surgery, Amri was required to remain completely flat in bed to protect the surgical site and allow proper healing.

For many children this is difficult.

For an active, strong-willed 3-year-old who was already uncomfortable and confused, it felt nearly impossible.

Within the first hour, nurses, physical therapy, occupational therapy, and the rehabilitation physician all stopped by to introduce themselves and begin planning for the days ahead.

Unfortunately, all of this happened while Amri was crying, screaming, thrashing, and desperately trying to sit up.

There were a lot of tears.

Amri’s.

And mine.

Before surgery, we had already discovered that Amri did not tolerate Gabapentin well, and Dr. Shah agreed it wasn’t the right choice for him. The initial plan was to manage pain primarily with Tylenol and ibuprofen.

As the day went on, the medical team worked with us to find the right balance between keeping Amri comfortable and maintaining the safety requirements after surgery. Eventually we were given additional options, including Valium, oxycodone, and morphine if needed.

We started with a half dose of Valium.

It made all the difference.

For the first time all day, we saw him relax.

Around that same time, Child Life stopped by with Dexter, one of the hospital’s service dogs. Unfortunately, the Valium had already started working and Amri fell asleep before he could really enjoy the visit, but it meant so much that they came.

One thing Amri has consistently complained about is back pain, which is very common after SDR surgery.

He also strongly dislikes the knee immobilizers he has to wear. These braces help prevent his hamstrings from tightening while he heals, but convincing a tired toddler of that logic is another story.

Another challenge was appetite. Amri had very little interest in food after surgery, which is common after anesthesia and major surgery. Our focus was mainly on keeping him hydrated and comfortable while waiting for his appetite to return.

Throughout the day he said things that absolutely broke my heart:

“I can’t walk.”

“We are staying here forever.”

And perhaps most frequently:

“I DON’T love you!”

Normally I’d take that personally, but considering the circumstances, I’m giving him a pass on this one.

We’ve spent a lot of time reassuring him that he is safe, that he is healing, and that this hard part is temporary.

We’ve reminded him that he is brave, strong, and working toward being able to move more freely than ever before.

Needless to say, none of us got much sleep.

I ended up sharing the hospital bed with him. He woke frequently throughout the night, and between medications, nurses, and monitoring, rest was hard to come by.

One thing that deserves mentioning is how incredible the staff has been. From the nurses to the therapy teams to Child Life, everyone has taken time not only to care for Amri, but also to answer our endless questions and support us through some emotional moments.

The first 24 hours after SDR were hard.

Really hard.

But we survived them.

And Amri did exactly what we’ve asked him to do:

Be brave.