Cerebral Palsy Program
Orthopaedic CP Clinic | Treatment Approach

A Minimally Invasive Approach for Children with CP

Orthopaedic surgeons at Cincinnati Children’s offer the full range of procedures for children with cerebral palsy. They perform many CP surgeries every year, with strong outcomes and low complication rates.

Orthopaedic Surgeries for Children Who Walk or Have the Potential to Walk

cerebral-clinic-carsonOrthopaedic surgery often can maximize a child’s ability to walk. Among the many surgeries for “walkers” are:

  • Tendon and muscle lengthening. This procedure treats muscle contractures and can help improve motor control and gait. The orthopaedic surgeon uses tiny incisions to minimize pain and shorten recovery time.
  • Tendon transfer. This surgery involves cutting a tendon and attaching it at a different location. It can improve alignment and muscle strength.
  • Osteotomy. This surgery corrects bone abnormalities that develop over time. It usually involves realignment of the bone in the hips and upper or lower extremities. The surgeon may use plates, rods or screws to hold the newly shaped or repositioned bone in place.
  • Guided growth surgeries. This minimally invasive approach harnesses your child’s own growth to help realign their bones or prevent abnormalities, with far less surgery, and a much easier rehabilitation.

Orthopaedic Surgeries for Children Who Are Not Able to Walk

Orthopaedic surgery for children with cerebral palsy who are not able to walk typically focuses on reducing pain and preventing long-term disability. These surgeries may treat:

  • Progressive scoliosis − a sideways curvature of the spine that worsens over time
  • CP hip dysplasia − abnormal growth of the hip joint
  • Arthritis − inflammation of the joints
  • Contractures − very tight, stiff muscles

Most children with CP who are not able to walk will develop some type of spinal abnormality. If conservative methods do not work and surgery is needed, Pediatric spine surgeons operate on these conditions often working in teams. This teamwork means shorter surgery, fewer complications and a quicker return to home.

Minimally Invasive Techniques

Cincinnati Children’s is a leader in providing minimally invasive orthopaedic techniques that improve the lives of children with cerebral palsy. Our approach helps children experience better outcomes and often avoid bigger surgeries later. Below are a few examples of the minimally invasive techniques our orthopaedic surgeons offer.

  • Single-event, multilevel surgery (SEMLS) allows the orthopaedic surgeon to do multiple procedures at once, rather than spreading them out over many years. It usually results in fewer surgeries total and only one course of rehabilitation. SEMLS can treat soft tissue and bone problems in the legs, hips and upper extremities.
  • Guided-growth techniques use a child’s natural growth pattern to guide bones, joints and tendons into more natural alignment.
  • Supplemental therapy interventions coordinated with surgery:
    • One example is serial casting (sometimes called extension casting), which involves using a series of casts on a joint. Each cast turns the joint a little farther in the direction it needs to go. Cincinnati Children’s was one of the first pediatric hospitals in the country to use guided-growth techniques.
    • Another example is functional electrical stimulation. This procedure delivers a low-energy current to muscles. Orthopaedic surgeons at Cincinnati Children’s use this therapy to help improve range of motion, muscle mass, muscle strength, walking speed, spasticity, gait, and foot and ankle positioning.