We care for special needs kids through their adulthood to assure consistency and continuity of care.
Cerebral Palsy is a disease caused by a one-time event whose consequences last lifelong. The immature brain is affected up to a year after birth caused by prematurity, meningitis, stroke, or the brain being deprived of oxygen. Cerebral palsy is a condition that affects the fine motor skills, coordination, movement, muscle tone, or posture of an individual on a spectrum that varies for each individual.
Many treatment strategies, from physical therapy to surgery, can help a child live more comfortably with these conditions and may see improvement in symptoms and complications. Children require a team of doctors for a multidisciplinary approach to treating patients with cerebral palsy. Our physicians at Medical City Children’s Orthopedics & Spine Specialists offer complex care for children with cerebral palsy, and they continue to provide for their needs from infancy throughout their adulthood. We work closely with our colleagues in other specialties, and our patients have full access to the wide variety of services provided by Medical City Hospital.
Our compassionate team strives to take care of the child emotionally and physically and our physicians take the time to spend with the patient and the patient’s family going over the psychological aspects of what to expect with cerebral palsy. The success of this program is how nimble and responsive to patients we are. We are able to take care of children who are often too sick to be treated at other facilities.
The success of this program is how we are nimble and responsive to 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.
Our board-certified orthopedic physicians can diagnose conditions in a child with cerebral palsy and determine the severity and how that condition will affect the child as he or she grows. Our physicians can also 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 and help parents learn how to prevent injuries or a worsening of any conditions related to the musculoskeletal system.
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 to reduce pain.
Hip dysplasia is an orthopedic health concern for children with cerebral palsy and is characterized by a deformity of the hip joint. This often occurs as a result of either over-or-under-toned muscles around the hip that cause the joints to become misaligned.
Hip dysplasia can be treated with surgery that realigns the hip joint and keeps the top of the femur in place in the joint. 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 with no arch or a very low arch. 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.
Cerebral palsy may cause a child to develop scoliosis, an abnormal curvature of the spine. The muscles of the back affected by cerebral palsy are not adequate to 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, particularly in the wheelchair group of CP patients.
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, to use non-invasive strategies like physical therapy, and to 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 cerebral palsy. In addition, cerebral palsy patients have a continuance of care through their adult years within the same medical practice.