Although cerebral palsy cannot be cured by surgery, for many children with CP, surgical interventions can present options for improving mobility and lessening pain. Surgery, in some cases, may be necessary to improve muscle tightness or correct bone abnormalities which are caused by spasticity.

Why Might Surgery Be Needed for Children with Cerebral Palsy, and How Can It Help?

Depending on the severity of a child’s cerebral palsy, surgical interventions may be needed to help improve the child’s quality of life and health. CP affects muscle growth and, in some cases, a discrepancy may occur between muscle growth and bone growth. This can lead to deformities of bones and joints, a loss of function, pain, and make care more difficult. In these cases, orthopedic surgery for cerebral palsy has a critical role to play. Orthopedic surgeons are typically involved in the treatment of spasticity, contractures, joint dislocations, bone deformities, and the overall improvement of musculoskeletal function and ambulation.

For some children, orthopedic surgery may be recommended to correct a problem such as hip dysplasia or scoliosis or when spasticity and stiffness are severe enough to make walking and moving difficult or painful. Additionally, children who cannot take adequate amounts of nutrition orally may need surgery for a feeding tube or to prevent reflux. Various surgery options can help your child with mobility, posture, alignment, and healthy growth.

Requirements for Orthopedic Surgery in Cerebral Palsy

The team of medical and rehabilitation professionals who are going to treat a person with CP must have:

  • Knowledge of normal anatomy and physiology, particularly regarding ambulation
  • A good understanding of the functional pathology present in CP
  • Realistic goals and objectives for treatment that are shared commonly by the patient’s family, and medical team
  • Knowledge and ability to carry out any of the treatments that are required
  • A facility with the resources to carry out the necessary evaluations and treatments

What Types of Surgery are Available for Cerebral Palsy Cases?

The following are some examples of surgical interventions for children with CP:

  • Tendon Release and Muscle Lengthening. Through muscle-lengthening surgery, surgeons can lengthen muscles and tendons that are proportionately too short, which can improve mobility and lessen pain. Orthopedic surgeries may be staggered at times appropriate to a child’s age and level of motor development.
  • Fundoplication. Anti-reflux surgery generally includes a fundoplication, which balances lower esophageal sphincter pressure by wrapping the upper stomach around the esophagus in the abdomen.
  • Harrington Rod Surgery. Involves spinal fusion to correct or greatly improve scoliosis deformities in children with CP. Scoliosis is a condition in which a person’s spine is curved. The condition can be classified as congenital (caused by anomalies present at birth), idiopathic (arising after birth and caused by unknown factors), or neuromuscular, where it is a secondary symptom of another condition such as cerebral palsy or spina bifida.
  • Tenotomy. Tenotomy is an outpatient surgical procedure for the hip, in which the doctor loosens a tendon in the hip joint that has become too tight due to incorrect positioning. This procedure is performed before other surgeries, such as open reduction, that place the ball-shaped top of the thigh bone into the socket.
  • Open Reduction Hip Surgery. Pediatric hip surgery for cerebral palsy is another surgical option for some children. In open reduction, the surgeon makes a small incision in the groin and removes excess tissue to make more room in the hip socket. The surgeon then places the ball of the hip joint back into the socket.
  • Hip Arthroscopy. Hip arthroscopy is a minimally-invasive procedure that is often performed to repair torn cartilage—a common complication of untreated developmental hip dysplasia in adults. Hip arthroscopy allows the doctor to obtain a detailed view of the hip joint while repairing the cartilage.
  • Osteotomy. Osteotomy is a type of surgery that may be used to deepen the hip socket and realign the thigh bone. The approach used depends on the patient’s age and the type of problem caused by developmental hip dysplasia.
  • Selective Dorsal Rhizotomy (SDR). SDR is a surgical procedure recommended for cases of severe spasticity when all of the more conservative treatments, such as physical therapy, oral medications, and intrathecal baclofen have failed to reduce spasticity or chronic pain. A surgeon locates and selectively severs overactivated nerves at the base of the spinal column. SDR is most commonly used to relax muscles and decrease chronic pain in one or both of the lower or upper limbs. Potential side effects include sensory loss, numbness, or uncomfortable sensations in limb areas once supplied by the severed nerve.
  • Cochlear implants. For children with CP who experience hearing loss or other severe hearing issues, a surgically implanted hearing device may be of great benefit.
  • Gastrostomy. Children with cerebral palsy and low muscle tone often experience issues with feeding, including aspiration or lack of muscle control, which makes it difficult to chew or swallow. A gastrostomy involves the surgical implantation of a feeding tube, which can help avoid some of the complications with feeding and make for an increased quality of life.

What Are Some Considerations Before Settling on Surgery?

Before scheduling your child’s surgery, consider the following questions to determine whether surgical interventions are the right move for your child:

  • Do the benefits of the surgery outweigh its risks? Research potential risks of any surgery you are considering for your child, and compare them with the potential benefits you are seeking.
  • What are some potential complications adherent to the surgery? Talk with your child’s medical team about some of the post-surgery complications that can arise. Consider the potential effects of those complications, and understand ways to minimize or eliminate them.
  • Which doctors, specialists, or other medical professionals should be consulted? Getting multiple opinions and having multiple discussions about the surgical options you are considering will allow you to consider the many different issues that may be involved in cerebral palsy surgery. Consulting your child’s entire medical team will also mean a more balanced understanding of the potential benefits, risks, and other factors to consider.
  • What will your child’s recovery look like? Be sure you understand what the recovery process entails, and what your family can expect to experience after your child’s surgery. Also, plan ahead and line up the help and support you will need after your child’s surgery and during the full recovery process.
  • Is this the right time for your child’s surgery? Growth stages and life changes can mean significant changes to your child’s symptoms. The timing of any surgical interventions is important, as the correct timing can maximize the benefits of surgery for your child.
  • What costs might you expect? Research and consider the possible costs of the surgery, recovery, and any adjacent costs that might affect your family’s finances.

If you suspect your child’s cerebral palsy was caused by medical negligence, contact the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs. Our years of experience, combined with our legal and medical expertise, enables us to uncover the truth and work to recover the compensation families are entitled to. Contact us today to let us help you and your family seek the justice you deserve.

Was Your Child's CP Preventable?