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Pediatric Orthopedics

Expertise in Pediatric Neuromuscular Disorders

The pediatric orthopedic experts at UH Rainbow Babies & Children’s offer advanced diagnosis, treatment and management for the full spectrum of neuromuscular disorders in children.

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What are the causes of neuromuscular conditions?

There are many different causes for neuromuscular conditions, and sometimes there is no known cause. Cerebral palsy, for example, has been associated with prematurity or low birth weight, but sometimes the cause is unknown. Some neuromuscular conditions are genetic. Though there are many types of muscular dystrophies, the most common types – Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) – occur almost exclusively in boys and are inherited from unaffected mothers. Still other conditions, such as Down syndrome, occur due to a chromosomal anomaly.

What treatments are available to children with neuromuscular conditions?

Many treatments for children with neuromuscular conditions focus on improving quality of life and mobility. Physical therapy, occupational therapy and speech-language therapy can be important early intervention tools and can continue to aid children as they grow. Braces and assistive devices (crutches, walkers, wheelchairs, etc.) can also be useful tools that can allow more movement and independence for older children.

Some children with cerebral palsy show significant improvement in spasticity (increased muscle tone) with physical therapy and oral medications. For other children, botulinum toxin (botox) injected directly into the involved muscle groups can provide improvement in muscle tone for a few months. Another option for treating spasticity is stretch casting to stretch the muscle and reduce tension.

Surgical intervention may sometimes be used to correct deformities or improve function in children with neuromuscular disorders. When other methods are unsuccessful in treating spasticity, some children may benefit from an intrathecal baclofen pump. The pump is surgically placed in the abdominal wall, where it pumps baclofen, a drug that decreases muscle tone. The medication is delivered to the spinal fluid through a tiny catheter (a small flexible tube) inserted in the spine. The drug is delivered directly to the nerves in the spinal cord that control the muscle tone in the arms and legs. With the pump, some children experience a significant improvement in their quality of life because of the increased flexibility and decreased muscle spasm pain.

What kind of future can I expect for my child?

While neuromuscular conditions cannot be cured, with proper treatment your child can have better mobility, more independence and improved quality of life. Our team of pediatric neuromuscular specialists, therapists and other experts work together to provide the best care for your child’s individual case and provide the necessary resources for families to navigate a neuromuscular diagnosis.

Why Choose UH?

The skilled team at UH Rainbow’s Division of Pediatric Orthopedic Surgery has demonstrated experience and skill in the diagnosis and treatment of neuromuscular disorders. Our specialized division treats nearly 12,000 pediatric patients with musculoskeletal problems each year and is ranked among the top 20 in the nation for pediatric orthopedics by U.S. News & World Report. We also offer a broader range of treatment options than most pediatric orthopedic departments, access to advanced technology not available everywhere, and a more comprehensive evaluation of your child and their needs.

Treating children with complex neuromuscular disorders demands state-of-the-art diagnostic capability and a highly skilled team of professionals to ensure optimal patient outcomes. Our multidisciplinary team includes pediatric orthopedic surgeons as well as experts in specialties such as neurology, developmental pediatrics, psychology, cardiology and genetics. Using our combined experience, we can help ensure that even the youngest child will get better results with fewer complications. In fact, two specific areas that are improving patient care include better pain control and reducing blood loss during surgery.

Our team is deeply involved in research that is aimed at developing new therapies and surgical treatments for children with neuromuscular disorders. Because of our specialists’ advanced training, we offer procedures only done by a handful of orthopedic surgeons across the U.S.

Conditions We Treat

Our expert team of neuromuscular specialists care for a range of conditions, including:

Breakthroughs in Neuromuscular Research

Through research and discovery, our physician scientists are involved in breakthrough treatments for neuromuscular diseases. One such study includes the use of a specialized external fixation device consisting of two rings connected by six pivotal, expandable struts that surround a misshapen bone like a tube. The device is attached to the bone at different points using wires. Adjusting the struts through computer navigation can shift the bone into better alignment, much like how braces straighten teeth. This new breakthrough requires expert insight into the bones’ growth plates, and in improving function and decreasing spasticity in the muscles of children with neuromuscular disorders. Others involve methods of spinal deformity correction in children who are still growing or have complex medical issues.

Our team participates in international collaboratives for spasticity management using Botox injections, medications and surgeries. This includes research on the use of an intrathecal baclofen pump to treat spasticity in children with neuromuscular disorders. The surgically placed pump delivers the drug baclofen directly to the nerves in the spinal cord that control muscle tone in the arms and legs. This drug can decrease muscle spasm pain and increase flexibility.

A Specialist for Every Need

Our pediatric orthopedic surgeons are preeminent leaders in their field. Children, adolescents and young adults benefit from having a highly specialized team that is able to treat the unique aspects of neuromuscular disorders.

Our team includes pediatric specialists from a range of clinical disciplines, all working together to manage every aspect of care for neuromuscular needs. The team includes specialists in:

  • Neurology
  • Orthopedics
  • Pulmonology
  • Cardiology
  • Gastroenterology
  • Pulmonology
  • Psychology
  • Genetics
  • Rehabilitation therapy
  • Child life therapy