The generosity witnessed towards a UK boy with cerebral palsy puts the spotlight on a surgical treatment that has been shown to help children with spasticity (from cerebral palsy) walk. Specifically, when this surgery, called Selective Dorsal Rhizotomy (SDR), is coupled with physiotherapy (PT), research shows that there is a reduction in spasticity (extremely tight muscles) and an improvement in motor function.
An eight year old boy named Joseph Hill has spastic diplegia and is totally dependent on a wheelchair and walking frame. When Joseph heard that enough money was raised to pay for his surgery, he was absolutely ecstatic, according to his mother, Mrs. Hill. She told journalists that Joseph wants the surgery done as soon as possible and that he wants to play football with his friends.
SDR is a neurosurgical procedure that selectively destroys problematic nerve roots in the spinal cord, most often to treat neuromuscular conditions, such as spastic diplegia and other forms or spastic cerebral palsy. SDR had been used by neurosurgeons since the 1980s. During SDR, the lower vertebrae are opened to reveal the spinal cord, which contains neurons of the central nervous system. These neurons (bundles of nerve fibers) channel messages between the brain and different areas of the body. Electrical stimulation is used to identify and sub-divide sensory and motor nerves. This procedure continues until the specific nerves and nerve roots affecting the spastic muscles are identified and cut. Due to the size of the nerves and rootlets, this is a very precise procedure and surgery can last several hours. It requires general anesthetic.
Many months of PT are needed after the surgery to retrain the legs. In fact, PT is necessary to obtain maximum benefit from the operation. PT after SDR typically is five times a week for two years.
Indeed, research shows that SDR coupled with PT provides significant benefit over PT alone. Spasticity is significantly reduced and there is improvement in function as measured by the Gross Motor Function Measure (GMFM). (The GMFM system is a classification system that describes the gross motor function of children with cerebral palsy on the basis of their self-initiated movement, with particular emphasis on sitting, walking, and wheeled mobility.) Spasticity, range of motion, and functional muscle strength typically improve through five years or more after surgery. SDR patients usually show sustained improvement in alignment and postural stability, as well as an increased ability to perform difficult transitional movements. There also are long-term improvements of gait (movement or propulsion using the limbs) abnormalities.
BIRTH INJURY, HIE AND CEREBRAL PALSY
Joseph sustained an injury inside his mother’s womb, at 34 weeks of gestation. Mrs. Hill went to the hospital when she felt no movement of baby Joseph. Joseph had to be delivered immediately by an emergency C-section. At six weeks old, the Hills were told that Joseph suffered brain damage due to a lack of oxygen to his brain around the time of birth. He was later diagnosed with spastic diplegia.
Cerebral palsy is a disorder that causes problems with movement and balance due to a brain injury that occurs during brain development, which is sometime near the time of birth. Sometimes cerebral palsy is noticed soon after birth, but in other children, the disorder won’t be noticed until a few years later. Babies with cerebral palsy are often slow to roll over, sit, crawl or walk, and may look weak and have poor head position. Cerebral palsy noticed a few years later in life is characterized by abnormal muscle tone, poor reflexes and motor coordination, permanently fixed / tight muscles (spasticity), spasms and other involuntary movements, unsteady walking, problems with balance, and scissor or toe walking. The symptoms of cerebral palsy typically last throughout life, but they don’t get worse over time.
Cerebral palsy can be caused by an infection that travels to the baby’s brain, brain trauma, brain bleeds and hemorrhages, and hypoxic ischemic encephalopathey (HIE). HIE is brain injury that occurs due to a lack of oxygen rich blood in the brain, either caused by restricted blood flow or decreased oxygen in the baby’s body.
Joseph was inflicted with HIE due to something that occurred around the time he was born.
CAUSES OF HIE
Listed below are some of the causes of HIE that can lead to cerebral palsy.
- Umbilical cord problems, such as cord prolapse and nuchal cord
- Uterine rupture
- Hyperstimulation of the uterus. This can be caused by improper use of Pitocin or Cytotec, which are labor induction drugs.
- Placental abruption
- Uteroplacental insufficiency. Anything that causes insufficient blood flow to the placenta during pregnancy can cause the baby to be oxygen deprived. This can occur when there is an abnormally thin placenta or problems with vessels and capillaries in the placenta.
- Polyhydramnios (excessive amniotic fluid). When there is too much amniotic fluid, there is a risk of cord prolapse, placental abruption and premature birth, all of which can cause oxygen deprivation in the baby.
- Oligohydramnios (insufficient amniotic fluid). Oligohydramnios can cause cord compression, and is associated with fetal growth restriction, meconium aspiration, preeclampsia and placental abruption, all of which can cause a baby to be oxygen deprived.
- Cephalopelvic disproportion (CPD) (mismatch in size between the baby and mother’s pelvis). If the baby’s head or body is too large to get through the birth canal (which can also occur in macrosomia), the baby is at risk of having a difficult and prolonged labor, which can cause trauma, brain bleeds and umbilical cord prolapse and compression.
- Breech presentation. If the feet or buttocks are positioned first to come through the birth canal, serious complications can arise, such as cord prolapse, nuchal cord, and head trauma and brain bleeds.
- Prolonged and arrested labor. When labor takes too long or fails to progress, the baby can become extremely distressed. In this situation, there is an increased risk of delivery instrument use, such as use of forceps and vacuum extractors, which can cause trauma to the baby’s head and result in intracranial hemorrhages and brain bleeds.
HELP FOR FAMILIES WHOSE CHILDREN HAVE CEREBRAL PALSY
If your baby suffered any birth complications and has been diagnosed with cerebral palsy, please contact the nationally recognized birth injury attorneys at Reiter & Walsh ABC Law Centers. For decades, we have been helping families in Michigan and throughout the nation whose children have cerebral palsy. We have numerous multi-million dollar verdicts that attest to our success, and we will fight to obtain the compensation you and your family deserve for lifelong care and treatment. We will evaluate your case to determine if your newborn suffered injuries due the the negligence of the physician or medical staff, and you never pay any money until we win your case. Call us at 888-419-2229.