Orthopedic surgery is often recommended when spasticity and stiffness are severe enough to make walking
and moving about difficult or painful. (Chambers, Oppenheim)The spine is monitored for scoliosis, and the
hips for progressive subluxation. In younger children, lengthening or transfer of contracted tendons may
suffice, supplemented by bracing to prevent early recurrences. For older children with bony deformities,
corrective osteotomies (resetting of the bony alignment) may be required. If surgery becomes necessary, it
is wise to do as much as possible at one setting (single event multilevel surgery (SEMLS)) both to keep
multiple levels in balance as well as to avoid having to operate too frequently through childhood.
Indications for surgery are generally different in ambulatory as opposed to non ambulatory children.
Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice.
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