Cerebral palsy can't be cured. But treatment can help your child manage the condition.
Not all treatments involve surgery. We work closely with Seattle Children's physical, speech and occupational therapists to improve your child's ability to move, speak and perform everyday activities, such as going to school. Our orthotics and prosthetics team provides braces and other devices that can help with balance, walking and movement. Medicines can help relax muscles spasms and control pain and seizures.
Some treatments do involve surgery. We screen children in our Neurodevelopmental Clinic to find out if surgery might benefit them.
Surgery for Cerebral Palsy and Spasticity
Neurosurgeons at Seattle Children’s do two surgeries to lessen spasticity in children with cerebral palsy.
Baclofen pump
In this procedure, neurosurgeons place (implant) a pump about the size of a hockey puck in your child's belly (abdomen). The pump continuously delivers a medicine called baclofen into the fluid surrounding your child's spine. Baclofen is a muscle relaxant that reduces spasticity throughout your child's body. Since the medicine goes directly into your child's nervous system, the dose of baclofen your child gets through the pump can be much lower than doses delivered through the mouth. This helps your child avoid the side effects of higher doses (sedation).
Before neurosurgeons put in the pump, we use a needle to inject a test dose of baclofen into your child's spinal canal. This procedure is called a lumbar puncture. We do this to be sure that baclofen is the right medicine for your child's system. After your child gets the medicine, a physical therapist watches for several hours to see the effect the medicine has on your child's body.
If you and your child's neurosurgeon agree that your child can benefit from a baclofen pump, the neurosurgeon does surgery to put the pump under the skin of your child’s belly. Once the pump is in place, the neurosurgeon attaches a thin tube (catheter) to it. Then the neurosurgeon threads the catheter under the skin at waist level to your child's spine. They insert the catheter into the spinal canal.
Next, the neurosurgery team fills the pump with baclofen and sets it to deliver the exact amount of medicine your child needs. The pump begins slowly releasing the medicine through the tube and into the spinal canal.
The baclofen pump must be filled with medicine every one to six months, depending on your child’s dose. You can refill it at Seattle Children’s or at another medical facility. It's important not to let the pump run of medicine. This could harm your child.
The pump lasts about five years. Afterward, it must be removed and replaced during another surgery.
Selective dorsal rhizotomy
Doctors recommend a selective dorsal rhizotomy for specific kinds of spasticity. Children who are good candidates for this operation have specific characteristics that are likely to benefit from the surgery. They also must be able to participate in prolonged physical therapy after the surgery.
During this operation, the neurosurgeon exposes the nerve roots at the bottom of your child’s backbone (spine). These are the nerves that go to the leg muscles. The neurosurgeon cuts about 30% to 50% of the sensory nerves here. This decreases the messages coming into the spinal cord from the nerves, and so decreases spasticity. This surgery can permanently change your child’s spasticity.