Surgery

Surgery for people with cerebral palsy (CP) may help reduce muscle stiffness or spasms and allow more flexibility and control of the affected limbs and joints.

The doctor evaluates the person's symptoms, age, and general state of health when considering whether to recommend surgery.

A thorough checkup is needed to help the doctor find out which muscles and nerves are affected and what type of surgery would best treat the condition. A gait analysis may be part of the exam.

For young children, surgery may be postponed if doing so will likely prevent the need for additional surgery in the future.

Other surgeries related to cerebral palsy

Surgery for various orthopedic problems: Surgery for other problems is sometimes needed for children with CP. These surgeries vary depending upon the specific problems involved. For example, some children may need surgery to correct uneven leg length, dislocation of the hip, or curves in the spine (scoliosis).

Medicine-related surgery: A small pump is surgically implanted under the skin in the abdomen for some people with CP. This pump is used to deliver medicines, such as baclofen (Lioresal), directly into the fluid surrounding the spinal cord. For more information, see Antispasmodics (Muscle Relaxants) for Cerebral Palsy.

Surgery Choices

The main surgery choices for people affected by cerebral palsy (CP) are:

• Orthopedic surgery (for muscles, tendons, and joints). It's done to increase range of motion. For example, the surgeon may lengthen a tendon, cut through muscles or tendons, or attach a tendon to a different part of the bone.¹ Surgery to treat spinal curves or to prevent or treat hip dislocation is also done.
• Selective dorsal rhizotomy (cutting nerves of affected limbs). This procedure is usually considered only for children who have severe muscle tightness in the legs.

What To Think About

Doctors do not agree about the best age for children with cerebral palsy (CP) to have surgery. Some may suggest surgery at a young age, while others may suggest other treatments before surgery. Use this surgery information form(What is a PDF document?) to help you decide what's right for your child.

Surgery is not used nearly as often for the arms as for the legs. Surgery on arm deformities carries more risks related to sensory damage. And surgery doesn't help with arm functioning as much as it helps with leg functioning.⁴

Sometimes medicines or physical therapy is used to postpone or get rid of the need for surgery.

The type of therapy and special equipment needed after surgery (such as braces, casts, and splints) depend on the child's specific needs. Most children need physical therapy after surgery. In general, post-surgical physical therapy usually starts as soon as possible and may continue for as long as 6 months.