Cerebral Palsy and Spasticity Center | Orthopedic Surgery

The orthopedic center at Boston Children’s Hospital is one of the oldest and busiest in the United States. Our orthopedic team is ranked #1 for pediatric orthopedic care by U.S.News & World Report and has expertise in a variety of disorders and conditions, including cerebral palsy (CP).

Orthopedics Surgery

Boston Children’s Hospital Orthopedic Surgery: Going Above and Beyond for Children with Cerebral Palsy

Our skilled surgeons bring vast experience and compassion to their work, making the comfort and overall well-being of your child our priority. While our treatments and innovations have greatly evolved over the past century, our philosophy remains the same—to relentlessly provide the best orthopedic care and patient service possible to improve our patients’ quality of life.

We accomplish this through:

  • Pioneering research studies: Many of our physicians are conducting clinical trials to get answers to the most pressing questions in pediatric orthopedics today—all in an effort to provide your child with the most innovative care available. Learn more about our cerebral palsy research.
  • Exceptional customer service: We believe that this is a key component to superior care. Our orthopedics department conducts patient satisfaction surveys, encourages outstanding customer service through its Gold Star program and even developed a concierge service—all in an effort to improve the overall patient experience.
  • Personalized pain management: We know you might have concerns about the pain your child may experience as a result of surgery. Pain is extremely well managed with regional blocks and anesthesia to ensure your child is comfortable before, during and after his or her procedure.

Orthopedic Surgery for Children with Cerebral Palsy

Children with cerebral palsy often cannot exercise or stretch their muscles by running, walking or playing, which can lead to poor muscle and bone growth. Weak muscles do not support the bones and joints as well they should, which can lead to conditions like:

  • Curvatures of the spine (scoliosis)
  • Hip displacement/dislocation
  • Ankle, foot, hand, knee and shoulder deformities

In some cases, surgery can be a helpful option for managing these symptoms, especially when other, less invasive medical treatments and therapies have been tried without success. Our orthopedic surgeons have many years of expertise treating CP symptoms that impact the skeleton and muscles.

Orthopedic surgeries focus on improving mobility and body movement. Surgery can also help reduce spasticity in the legs by elongating or releasing the contracted muscles and tendons that are too short and improve bone alignment. This can help prevent some of these conditions.

Correcting Curvatures of the Spine Caused by Cerebral Palsy

Spastic muscle activity in children with CP results in uneven pulling on the spine. This can cause the spine to curve (scoliosis). Curvatures can make sitting difficult and may cause your child discomfort. Spinal surgeries can correct a curvature and prevent it from getting worse.

Spinal Fusion to Treat Scoliosis

Almost all spinal surgeries for CP will involve some type of spinal fusion. Spinal fusion is a surgical procedure that:

  • Permanently stabilizes the vertebrae of the spine by stimulating bone growth and uniting (fusing) the separate vertebrae
  • Prevents the curve from worsening
  • Often involves the use of instruments like metal rods, hooks, screws or wires to partially straighten the spine and help hold the vertebrae in a stable position while healing occurs

Some curvatures are more severe than others. Our expert surgeons will straighten the spine only as much as is safe for your child.

Growing Rods for Young Spines

In young children who are still actively growing, spinal curves get worse quickly. While we want to stop the curves from getting too big, we also want to allow as much growth as possible through the spine. To do this, your child’s doctor may recommend growing rods.

These extendable metal rods are:

  • Attached to the spine above and below the curve
  • Inserted without doing a complete spinal fusion, to allow continued growth
  • Require a moderate-sized surgery 

Your child will return for lengthening of the rods as a day surgery or overnight stay every six months or so. Lengthening continues for several years and is generally followed by a final spinal fusion once your child is nearly done growing.

To learn more about spinal surgeries at Boston Children’s, download A Guidebook for Spinal Surgery in Children with Neuromuscular Disorders (PDF). Created by clinicians in the Cerebral Palsy and Spasticity Center at Boston Children's, this booklet discusses various spine disorders your child may encounter, as well as surgical treatment options.

Hip, Leg, and Ankle Surgery for Children with Cerebral Palsy

Children with CP often have weak muscles that do not support the bone and joints as well they should. This can lead to hip dislocation and foot and ankle deformities. Boston Children’s orthopedic surgeons offer many treatments for these conditions, including:

  • Muscle lengthenings: Sometimes the muscles and tendons attached to the legs and hips become tight and pull on the bones, which can cause joint dislocation. These tendons can be surgically lengthened to relax and allow more stretch. These procedures are done through small incisions.
  • Femoral osteotomy: If your child’s thigh bone (femur) is too straight and not pointing to the hip correctly, the doctor may decide to cut the femur and reposition it to point into the hip at a better angle. It will be reattached with plates and screws. Sometimes the bone also has to be turned to allow the knee to face forward.
  • Pelvic osteotomy: This hip surgery is done to help create a better shaped cup to hold the ball of the femur. There are many types of pelvic osteotomy but all aim to help your child be more comfortable and achieve the greatest mobility possible.

To learn more about hip surgery at Boston Children’s, download A Guidebook for Hip Surgery in Children with Cerebral Palsy (PDF). Created by clinicians in the Cerebral Palsy and Spasticity Center at Boston Children's, this booklet discusses various hip conditions your child may encounter, as well as treatment options.

Make an Appointment

For an appointment, more information or to obtain a second opinion for your child, please call us at 617-355-6021 or request an appointment online.

International Patients

For families residing outside of the United States, please call Boston Children's International Health Services at 1-617-355-5209.