Pediatric Orthopedic Surgeons

CEREBRAL PALSY

Cerebral palsy patients who come to Medical City Children’s Orthopedic and Spine Specialists as children have the continuity of care through adulthood.

We care for Cerebral Palsy kids through their adulthood to assure consistency and continuity of care.

Cerebral Palsy

Cerebral Palsy Causes

A one-time event causes Cerebral Palsy and it creates health consequences that last a lifetime. The immature brain becomes affected — up to a year — after birth and is potentially caused by prematurity, meningitis, stroke, or the brain being deprived of oxygen. Cerebral palsy affects motor skills like coordination, movement, muscles, or posture on a spectrum that varies for each person.

Cerebral Palsy Treatment

Many treatment strategies, from physical therapy to surgery, can help a child live more comfortably with these conditions. Children with Cerebral Palsy require a team of doctors for a multidisciplinary approach as we offer complex care for them.  Our doctors will devise a treatment plan for your child and continue to provide for their needs from infancy throughout their adulthood. We work closely with our colleagues in other health specialties, and our patients have full access to the wide variety of services provided by Medical City Hospital.

Cerebral Palsy Specialist Doctors

Our compassionate team strives to take care of the child emotionally and physically.  Additionally, our doctors take the time to visit and talk with the patient and the patient’s family.  Discussions include the psychological aspects of cerebral palsy. The success of this program relies on the advanced health care we provide. We possess the knowledge, skills, and abilities to take care of people with cerebral palsy who are often too sick to be treated at other facilities.

Cerebral Palsy and back problems with Children

The success of this program relies on the advanced health care we provide to our patients

 

“Two broad groups of patients with cerebral palsy are those who walk and those who are wheelchair dependent. The goal is to perform surgeries and tailor treatment that keep people walking throughout their lives whenever possible. Our physicians try to perform single event multi-level surgery (SEMLS), one operation that takes care of many issues at once, to avoid a cumulative effect of many surgeries.” Shyam Kishan, M.D.

Orthopedic Health

Our board-certified orthopedic physicians diagnose conditions in a child with cerebral palsy. Then the doctors will determine the severity and how that condition will affect the child as he or she grows. Also, our physicians can recommend and administer treatment, including surgeries, to help correct damage or improve movement. Our team of specialists will take the time to consult with you and your child. We try and help parents learn how to prevent injuries or a worsening of any conditions related to the musculoskeletal system.

Muscle Contracture

While cerebral palsy cannot be cured and is not progressive, living with orthopedic conditions can be limiting and even painful. Several conditions may affect a child with cerebral palsy, and many can be treated to improve mobility and reducing pain.

Hip Dysplasia

Hip dysplasia is an orthopedic health concern for children with this condition.  It is characterized by a deformity of the hip joint. Additionally, this often occurs as a result of either over-or-under-toned muscles around the hip.  As a result, hip dysplasia causes the joints to become misaligned.

Hip dysplasia can be treated with surgery to realign the hip joint and keep the femur in place. Physical therapy may also help prevent dysplasia by working on the tone of the muscles surrounding the joint. Therapy may also help a child move in a way that prevents further damage to the joint.

Foot Orthopedic Health

Abnormal contractions of muscles in the feet of a child with cerebral palsy can lead to a flat foot. Spasticity or increased muscle tone often causes this. When the tone of muscles in the ankles is too high, a child may develop toe-walking. The contracture of the muscles makes a child walk on his or her toes or on the balls of the feet.

Physical therapy to stretch the muscles or casts along with Botox and physical therapy can help improve the way in which a child walks. If these strategies do not help, surgery can be used to lengthen the Achilles tendon.

Scoliosis

Cerebral palsy may cause a child to develop scoliosis, an abnormal curvature of the spine. The back muscles affected by cerebral palsy do not support the spine, and this can cause curvature. Scoliosis appears like a C- or S-shaped curve in the spinal column. Although cerebral palsy itself is not progressive, scoliosis is a condition that can get worse with time.  If not treated, wheel chair patients seem to get worse more rapidly.  

A back brace is a common treatment to support the spine when the muscles cannot and to encourage normal growth. When the curvature is severe or is impairing a child to a high degree, surgery may be recommended. We also have technology such as the MAGEC rod to perform “Growth Friendly” Spine Surgery that helps the child’s spine grow as the correction is affected.

Other Orthopedic Health Concerns

A child with cerebral palsy may have one leg longer than the other, to a degree that makes walking difficult or uncomfortable. Surgery can be used to shorten the longer leg, but this is usually only done when the difference is more than two centimeters. Otherwise, a lift in the shoe is typically adequate to improve mobility and comfort.

Torsion in the legs is another possible issue. This occurs when the legs either twist in or out, and it can make walking difficult. A surgical procedure can be used to cut the affected bone, usually the femur or tibia, and reposition it with surgical pins and plates. The correction usually improves the gait and ability to walk.

The Importance of Monitoring Orthopedic Health and Using Treatments

Orthopedic health is important because it affects how a child moves. When orthopedic health is compromised, a child may be limited in mobility and may even be in pain or discomfort. Cerebral palsy does not get worse with time, but the abnormalities it causes in muscles can cause orthopedic conditions. These can get worse with time if not addressed and treated.

To give a child with cerebral palsy the best opportunity for a full life, it is crucial to monitor orthopedic health, use non-invasive strategies like physical therapy, and resort to surgery only as needed. Due to our expertise and experience, our pediatric surgeons perform with less anesthesia and blood loss and a lower risk of infection than the average. Ongoing physical therapy is especially important, as it helps joints and bones stay in the correct alignment and can prevent problems or keep them from getting worse.

If you have a child with cerebral palsy, our physicians at Medical City Children’s Orthopedic and Spine Specialist have expertise in pediatrics and all the challenges associated with your child’s unique condition. In addition, cerebral palsy patients have a continuance of care through their adult years within the same medical practice.

Therapy Treatment

Children with Cerebral palsy respond well to different kinds of therapy.  And as the child grows older therapy can provide physical, mental, social, and academic benefits. Thus, it’s important to start early with therapy as it can reduce impairment and the risk of developing other conditions associated with cerebral palsy.

There are several different kinds of therapy, but not only is therapy beneficial to the child, but it is extremely helpful to parents and caregivers. For example, nutritional therapy can help caregivers understand specific dietary needs, while behavioral therapy can teach parents the benefits of positive reinforcement. Meanwhile, our doctors will work with families to determine the child’s best therapies and develop a sound individualized plan with goals.

Here are some of the therapies that we recommend for children with cerebral palsy.

Physical Therapy

Physical therapy is one of the most important forms of treatment for children with cerebral palsy. Also, most physicians recommend physical therapy for all children with cerebral palsy, regardless of how minor or severe the disorder is.

Goals of Physical Therapy for Children with Cerebral Palsy

Children diagnosed with cerebral palsy will have various degrees of muscle control, balance, and mobility, depending upon how severe the disorder is. Physical therapy helps with these issues by assisting children with balance, posture, crawling, climbing, walking, and muscle strengthening.

In addition, physical therapy helps children with cerebral palsy to:

  • Decrease the chance of joint contractures and bone deformities Overcome physical limitations
  • Expand the range of motion
  • Use adaptive equipment
  • Increase fitness, flexibility, balance, and posture
  • Reduce physical discomfort and pain
  • Increase independence
  • Improve muscle tone

Interaction Therapy

Interaction therapy assists children with cerebral palsy to improve socially while they are at home, at school or in the community, and later in life, at work. In addition, this type of therapy helps children successfully carry out social tasks needing to be accomplished each day.

A typical occupational therapy session consists of the child being trained and guided by a therapist to work on exercises that will improve function and help with activities of daily living. Most importantly, the child’s current abilities, as well as limitations, will be used to create a customized plan.

Speech Therapy

When a child has cerebral palsy, they often have trouble forming words correctly and this is where speech therapy really helps them communicate more effectively. Therefore, a speech and language pathologist can implement ways for the child to communicate successfully taking into account individual strengths and weaknesses.  In some cases, this can be done through sign language, cues, and the use of other tools.  With experienced speech therapists, goals are set to help these children communicate as effectively as possible.

Aqua Therapy

Aqua therapy helps a child with cerebral palsy to improve muscle tone and physical functioning. It’s especially beneficial for children with cerebral palsy who are unable to walk without assistance.

This type of therapy takes place in a swimming pool and combines both aerobic and anaerobic exercise in a way that’s easy and fun for children with cerebral palsy to perform.

Massage Therapy

Massage therapy is extremely beneficial to children with cerebral palsy, as it improves muscle tone and function.

Research indicates that massage therapy is a proven way to help children with cerebral palsy benefit therapeutically. It can also help children deal with chronic pain due to joint contractures, scoliosis, and spasticity.

Play and Social Therapy

Regardless of disabilities, almost all children enjoy playtime. Although playing is something that tends to be natural and comes easily for most children, those with cerebral palsy may find it a bit more challenging than others.

Play and social therapy give parents, caregivers, and loved ones the opportunity to see how the child interacts socially during play. This can be extremely beneficial, especially for children who have difficulties with communication.

Music Therapy

According to the American Music Therapy Association (AMTA), music therapy helps to establish a therapeutic relationship between the child in therapy and the instructor. Furthermore, children who participate in music therapy may experience improvements in learning, motivation, relaxation, and language skills.

Behavior Therapy

Behavioral therapy helps children that are having difficulties with emotions and who act out through inappropriate behavior. Behavior therapy uses positive reinforcement to help change negative behavior into more desirable, adaptive behavior patterns.

Thoughts, beliefs, and emotions are explored via behavioral therapy, which helps the therapist mediate difficult situations the child is encountering and, in turn, improve confidence and well-being.

Call 214-556-0590 to make an appointment.
Cerebral Palsy services for children from birth through adulthood to maintain consistency of care
at three convenient locations: Arlington, Dallas, Frisco and McKinney.