Neuromuscular Disorders

Neuromuscular disorders originate in the brain and nervous system, but affect the child’s muscular system, causing problems with muscle tone, balance, mobility, and motor skills.

Children with neuromuscular disorders will work with specialists in several different fields to receive treatment, including physical therapists, neurologists, and speech and language pathologists. Because neuromuscular disorders also cause problems with the musculoskeletal system, orthopaedic surgeons are also involved in the care process.

At Children’s Orthopaedic & Scoliosis Surgery Associates, our neuromuscular disorder specialists include Dr. Bland, Dr. Phillips, Dr. Hahn, Dr. Neustadt, and Dr. Wilson. Our specialists are trained in nonsurgical treatment methods for neuromuscular disorders, and have fellowship training in pediatric orthopaedic surgery. We are also experienced in coordinating with other specialists to provide comprehensive care to our patients, and are affiliated with Johns Hopkins All Children’s Hospital. Our goal is to work with your child’s care team to avoid or delay surgery whenever possible. When surgery is needed, we try to perform multiple procedures at once to minimize the need for anesthesia and reduce recovery times.

Learn more about how our team assists in the treatment of neuromuscular disorders

Cerebral Palsy Treatment

Cerebral palsy is one of the most common neuromuscular disorders that we treat at Children’s Orthopaedic. Cerebral palsy can result in increased or low muscle tone, which may affect one or more of the limbs. Muscle tone imbalances can affect a child’s mobility and cause problems with gait and joint function. Children with cerebral palsy require ongoing treatment, because there is no cure. However, regular nonsurgical treatment combined with surgical procedures, when needed, can help to ensure your child remains as mobile as possible while reducing pain and other functional issues.

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Spinal Deformities

Neuromuscular disorders can also result in spinal deformities like scoliosis. Scoliosis occurs when the spine develops an “S” or “C” curve. Neuromuscular scoliosis develops due to weakness, poor muscle control, or paralysis caused by conditions like cerebral palsy, muscular dystrophy, spina bifida, and polio. Treatment options depend on the severity and progression of the curvature, and may involve bracing, Mehta casting, or surgery.

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Hip Subluxations & Dislocations

Hip subluxation occurs when the hip is partially displaced from the socket. This is a common condition among patients with cerebral palsy and other neuromuscular disorders due to abnormal muscle form that pulls the hip away from the socket, rather than keeping it in place. If the displacement of the hip progresses over time, it can lead to complete dislocation. For patients with neuromuscular disorders, it is especially critical to address hip problems so that the child does not develop early onset arthritis.

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Foot Deformities

Foot and ankle deformities like flat foot, clubfoot, high arches, and toe walking are also common in children with neuromuscular disorders due to abnormal muscle tone. Because children with neuromuscular disorders typically have problems with muscle stiffness, foot deformities often have more of an adverse effect on gait and mobility than they would in otherwise healthy children because they cannot compensate for functional problems with the feet. Treatments include both surgical and nonsurgical options to help correct the deformity and improve function.

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Rotational & Gait Abnormalities

Neuromuscular conditions can cause rotational abnormalities of the femur, tibia, and or foot, with the bones being twisted out of normal alignment. Children may develop in-toeing or out-toeing as a result of these abnormalities, which can ultimately affect the child’s gait and mobility. These abnormalities may also contribute to other conditions, such as hip subluxation or dislocation.

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Contracture Affecting Function

Neuromuscular disorders often result in muscle contracture that affects normal function. This can ultimately affect range of motion with the limbs and cause perineal hygiene issues. If nonsurgical treatments like physical therapy, bracing, botox and medical management of spasticity do not do not provide sufficient help with muscle contracture, our surgeons can perform procedures to release or lengthen tight tendons. These procedures allow for greater flexibility and function of the affected limbs.