Information for the public


Orthopaedic surgery

Orthopaedic surgery can sometimes be important in treating spasticity and its complications. Some children and young people may be offered an assessment by an orthopaedic surgeon (who specialises in problems affecting bones and joints) to see if surgery could help them. Surgery might help some children and young people with:

  • a displaced hip

  • curvature of the spine

  • difficulties with arm or leg function due to muscle shortening, contractures or bony deformities

  • difficulties with hygiene in skin creases at the wrist, elbow or hip (for example, if the child's elbow is too bent to allow easy washing)

  • concerns about their appearance because of how their arm or hand looks.

Before surgery the healthcare team should discuss with you and your child the aims of the surgery and how likely your child is to achieve them, what the surgery will involve, and any specific risks. They should also discuss the care your child will receive afterwards. This is called a rehabilitation programme. It will involve physiotherapy, and possibly other treatments such as orthoses or drug treatment.

If your child needs several surgical procedures the surgeon will aim to do these at the same time if possible. If your child has had surgery to improve their walking, it may take 1 to 2 years for the full effects of the treatment to be achieved, so they should have an assessment of their walking 1 to 2 years after the operation.

Selective dorsal rhizotomy

Selective dorsal rhizotomy is a major surgical procedure that aims to improve walking in those children and young people who are already walking with aids or likely to walk with aids (such as a walking frame). It involves cutting selected nerves in the lower spine to reduce spasticity. Your child's doctor should discuss this procedure with you and your child, including the problems it might cause, that the treatment is irreversible, and that the effects of the treatment in the long term are unclear.

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