What Are the Surgical Options for Cerebral Palsy?

Several different surgeries can be done for cerebral palsy. Orthopedic surgery is a common option. It can be used to improve posture, balance, walking, and movement. There are eight primary types of orthopedic surgery for cerebral palsy.

Types of orthopedic surgery for cerebral palsy include:

• Muscle lengthening: Muscle lengthening is a procedure that lengthens the muscles to relieve tightness in the hands, fingers, arms, or legs. It can also help improve fine motor skills.
• Tendon lengthening: Tendon lengthening is done to improve walking and the ability to sit independently. It can also reduce painful contractures.
• Tendon transfer: A tendon transfer moves a tendon to another region across the joint to counteract an overly strong or stimulated muscle. It can also help reduce pain and to correct difficulties walking.
• Osteotomy: An osteotomy is done to realign the joints and improve posture. It’s often done after a hip dislocation.
• Myotomy: During a myotomy, cuts are made in the muscles. These cuts help improve muscle control and function.
• Tenotomy: A tenotomy is a procedure done on tendons where cuts are made in the tendons, similar to a myotomy.
• Arthrodesis: An arthrodesis fuses bones to increase stability. It can make walking easier.
• Joint replacement: If joints have become painful or dislocated, surgery may be done to replace them.

It’s also common for children with cerebral palsy to have neurological surgeries. These surgeries treat the nerves to improve muscle control, walking, balance, and other symptoms.

For instance, in a procedure called selective dorsal rhizotomy the nerves in the spinal cord that control muscle stiffness are cut. It’s sometimes an option for children with severe spasticity.

Sometimes, children with cerebral palsy also have surgery for complications of the condition. This can include eye surgeries, cochlear implants for hearing, gastrotomies to address nutrition difficulties, and more. A doctor can discuss the best surgical treatment options for each person.

The potential benefits of surgical treatment for cerebral palsy depend on the exact surgery and the individual. Common benefits include:

• pain relief
• reduction of tremors
• correction of spinal curvature
• correction of any limb, hand, or foot abnormalities
• improved balance
• improved posture
• improved coordination
• improved ability to stand
• improved ability to emulate or walk
• release of locked joints
• release of contractures
• prevention of hip dislocation

But surgery is invasive and has risks. Typically, doctors recommend trying treatments such as physical therapy, medications, and injections before surgery. Risks of surgery can include:

• infection
• bleeding
• no reduction in pain
• no relief of symptoms
• blood clots
• reactions to the anesthetic
• damage to the surrounding area

A doctor or orthopedic team will discuss the risks and benefits with you before any procedure. If you have special concerns, it can be helpful to write down a list of questions for them.

The recovery timeline can vary depending on the exact surgery. After any surgery, there will be healing time. It’s common to have splits, braces, or casts after orthopedic surgery. After some orthopedic procedures, crutches or wheelchair use might also be needed.

A doctor might prescribe additional pain medications in the weeks following surgery for cerebral palsy. The levels of pain you experience may be temporarily higher as your body heals from the surgery.

Physical therapy sessions will be especially important after surgery. A physical therapist will help improve skills such as balance, strength, and mobility. Sometimes, physical therapy is done during an inpatient recovery program. Other people recovering from cerebral palsy surgery might have few outpatient physical therapy appointments each week.

The exact cost and coverage for cerebral palsy surgery will depend on multiple factors. For instance, the exact surgery, your specific insurance, your state, and details such as your deductible will all make a difference in the total cost.

Many children with cerebral palsy in the U.S. have health insurance coverage through programs such as Medicaid or the Children’s Health Insurance Program. These programs are overseen by individual states, so exact coverage amounts depend on where you live.

You can start researching potential costs by searching your insurance plan for any information about common cerebral surgeries. You’ll need the International Classification of Diseases, Tenth Revision number (ICD-10) to do this. These are identification numbers that insurance companies use for different surgeries and procedures.

For cerebral palsy surgery, you can start with:

• G80.4: Cerebral palsy.
• M65.00: Access to tendon.
• Z98.89: Osteotomy, history of osteotomy.
• Z98.1: Arthrodesis.

Several surgeries can be part of a cerebral palsy treatment plan. Surgery for cerebral palsy can help lower pain while improving important factors such as balance, gait, posture, and stability.

Orthopedic surgeries are the most common surgeries for people with cerebral palsy, but neurological, vision, gastrointestinal, and other surgeries are also sometimes options. A doctor can work with a family to discuss how surgery fits into a treatment plan, along with options such as physical therapy and medication.