Phase II Randomized Study of Selective Dorsal Rhizotomy and Physiotherapy Vs Physiotherapy Alone for Spastic Diplegia

PROTOCOL ENTRY CRITERIA: --Disease Characteristics-- * Spastic diplegia, i.e.: Measurable spasticity with more lower than upper limb involvement * Fair to good trunk and head control * Little or no bulbar involvement * Able to walk or has potential to walk indoors with assistive devices * No fixed musculoskeletal deformity greater than 15 degrees * Prior orthopedic surgery acceptable if spastic muscle group is in physiologic biomechanical position and retains voluntary power * No detectable athetosis, rigidity, ataxia, or other movement disorder * No disease-related, treatable condition that may become urgent during study, e.g., hip subluxation requiring adductor release --Patient Characteristics-- * Age: 3 to 18 * Other: Intelligence Quotient greater than 50 Developmental age 3 years or higher * Able to follow multi-step commands * Expressive communication skills at 3-year level or higher * Mild dysarthria or drooling does not exclude * Stable social environment * Regular school and physical therapy attendance * Normal psychiatric status * Guardian able to give support and follow-up care * No medical contraindication to anesthesia or surgery, e.g.: Previous anesthesia reaction * Chronic lung disease * Uncontrollable seizures * Scoliosis Vertebral anomaly * Neural tube defect * No visual impairment sufficient to hinder mobility * Able to come to Children's Hospital and Medical Center for follow-up Insurance coverage adequate for surgery and postoperative physiotherapy