Infant cerebral palsy consists in permanent developmental, movement and posture disorders, with consequent limitations in the motor and intellectual abilities of affected children. It is caused by an irreversible damage to the central nervous system that happens during the brain development of the fetus, the newborn or the toddler. There are many causes and in Italy this condition affects one in five hundred children.
Functional surgery is one of the few options available to make life better for children with cerebral palsy. Professor Nicola Portinaro, supervisor of pediatric orthopedics at Humanitas, spoke about it, at the Italian TV program “Unomattina” on RAI1.
What is the link between infant cerebral palsy and neuro-motor disorder?
“The central brain disorder is irreversible and it affects the brain. This disorder increases the activity of muscles, as well as their tone and spasticity, making them grow less than the bones. For this reason, there are progressive deformities in the musculoskeletal system, especially in joints. A really early surgery helps avoid future heavy repercussions.
This disease affects each child differently, both in light and serious ways. For example, some children can’t even get out of bed and move. According to the body mass and quantity of limbs that are involved, we can speak of monoplegia, diplegia or tetraplegia”.
Technology can help
“Nowadays surgery uses many technologies, such as walking analysis and walking bio-mechanics, that allow us to quantify errors both in the movements and in the strength of joints of each child.
Ten years ago, Humanitas has developed the EMMA protocol for very early, multi-level, functional surgery, to make patients recover all their motor abilities. Late surgery is also possible, but it is much more taxing and biologically costly”, Prof. Portinaro points out.
Hip surgery
“These patients’ femoral heads are often not contained anymore in their natural cavity (the acetabulum). Early surgeries insert a little screw into the hip (inside the femoral neck) to make the femoral head stay inside the acetabulum while the child grows.
So, early surgery allows an immediate rehabilitation with short hospitalization in case of hip dysplasia”.
Knee surgery
“Knees are also paramount for movement. The bone grows proportionally more than the muscle, so this creates a bend that makes it impossible to walk normally. Early surgery can repair this bend, thanks to little screws and plaques in the knees. Children may start their rehabilitation the day after the operation”.
Foot surgery
“Deformities in feet make it impossible to walk normally and to push against the ground in the right way. Early surgery, in this case, consists in inserting a screw to immediately correct the foot. In fact, the patient only stays in hospital for a few hours and then they may start walking immediately”, Professor Portinaro concludes.
