Neuromuscular Disorder Treatment

Physicians at Emory strive to offer comprehensive orthopedic care for children with neuromuscular disorders such as cerebral palsy, muscular dystrophy, and Down's syndrome, amongst others. Much of this care can involve coordination of physical and occupational therapy for children, wheelchair fittings, and orthotists to help with braces.

The doctor may recommend various nonsurgical treatments:

  • Physical therapy - The doctor may prescribe daily stretching exercises to improve the child's ability to walk. Regular, moderate physical therapy may help maintain range of motion in stiff or "frozen" joints.
  • Bracing - Walking braces for the ankle-foot or the knee-ankle-foot can help support weak muscles and keep the body flexible, slowing progression of contractures.
  • Medications - Sometimes a doctor may prescribe anti-inflammatory corticosteroid medications to improve muscle strength and delay progression of muscular dystrophies. These medications can cause serious side effects.
  • Assistive devices - Rehabilitative devices such as canes, walkers, wheelchairs, strollers, and electric wheelchairs can help maintain the child's mobility and independence. Sometimes it helps to make modifications to your home, such as widening doorways and installing wheelchair ramps. Eventually, as respiratory muscles weaken, the child may also need the assistance of a breathing device, or ventilator.

Surgical Treatment for Pediatric Neuromuscular Disorders

Surgical management for these conditions may be indicated to assist your child in daily activities such as walking, running, and even sitting. These procedures are complex and need to be individualized to each patient to maximize outcome.

Some commonly performed procedures include:

  • Botulinum toxin-A injections for muscle spasticity
  • Tendon lengthening or transfers
  • Bony realignment procedures known as osteotomies
  • Hip reconstruction
  • Spinal fusion surgery*

*Spinal fusion is often performed for scoliosis but may also be required for neck disorders, chest wall deformities, or kyphosis (roundback).

Pediatric Orthopedics