Types of Cerebral Palsy Surgeries
While not ever person with cerebral palsy requires surgery, some children have symptoms so severe that certain surgeries are recommended. There are several types of surgical procedures that doctors might use in an effort to make movement easier for children with cerebral palsy. Many are designed to loosen tight muscles and ease tension on fixed joints. Other surgeries are designed to sever nerves that cause spasms so that the patient will have better control over their limbs.
Before a doctor will perform surgery on any child, it will be necessary to assess the patient in order to determine which nerves and/or muscles are affected. This assessment allows the surgeon to determine which surgery (if any) would be the best choice for treating an individual patient’s symptoms.
Types of Surgery
There are several choices for making life easier for patients with cerebral palsy, but the two main choices are as follows:
- Orthopedic Surgery to increase the patient’s range of motion, which may also involve surgery to correct spinal curves or prevent dislocation of the hip.
- Selective Dorsal Rhizotomy to correct problems with the child’s mobility (this surgery is usually reserved for children who suffer from severe tightness in the leg muscles).
- S.E.M.L.A.R.A.S.S. (Single Event Multilevel Lever Arm Restoration and Anti Spasticity Surgery) to give the growing child’s muscles and bones an opportunity to “grow in” correctly.
Some surgeries are specifically for orthopedic problems (such as uneven leg length, hip dislocation, and scoliosis). Another type of surgery involves implanting a small pump under the skin and delivering antispasmodic medication (Baclofin) directly into the spinal cord.
Choices in Orthopedic Surgery
The type of surgery doctors choose to perform on an individual with cerebral palsy depends on the location of the muscles that are affected. What they hope to achieve with surgery is to loosen affected muscles in order to allow the child more freedom of movement so he or she can walk and sit more easily.
Surgery is not necessary or even appropriate for every child, but when it can improve the quality of life, surgery is definitely an option worth considering. There is one thing to keep in mind. While some types of surgery may be quite effective, as the individual matures and grows, there may be a need for additional surgery if those muscles (or other ones) tighten and lead to the development of contractures.
Other common surgical procedures for those with cerebral palsy include the following:
- Gastroenterology surgery – To help improve feeding, digestive, and bladder or bowel functions.
- Audio correction surgery – To help improve auditory functions through the use of hearing aids or radio aides.
- Surgery related to medication – To assist with the allocation of medication through a pump or lumbar puncture for those with chronic pain and/or spasticity.
- Neurosurgery – Neurosurgical interventions can sometimes assist in the management of cerebral palsy.
- Surgery to correct vision – This might include treatment of vision problems common in CP patients such as cortical blindness, hemianopia, and strabismus.
When Should a Child with Cerebral Palsy Undergo Surgery?
There is some disagreement within the medical profession about the best age for surgery. In some cases, doctors may wait until the child passes his or her 2nd birthday. By waiting until this time, the doctor may be able to affect many more of the child’s tight muscles in one surgical procedure. Some surgeons state that children younger than 2 benefit the most from orthopedic surgeries, because it allows them to develop better in the long run. For certain types of surgical procedures, the recommended age may even be between the ages of 6 and 8.
Surgery is not always the best option for cerebral palsy. Sometimes the best strategy is medication and physical therapy. Recommendations about surgery need to come from your child’s doctor. Of course, the parents and/or patient have the final option to accept or decline any recommendations for surgery, but try to work with your child’s physician to come up with an overall treatment plan that all parties are comfortable with.