Overview of the treatment of cerebral palsy
The treatment of cerebral palsy is multifaceted. The main treatment lies in muscle training, speech training and psychotherapy. Surgery can only be used as an adjunctive treatment and requires continuous rehabilitation before and after surgery.
I. Non-surgical treatment
1.Motor rehabilitation therapy: PT, OT; Speech therapy: ST.
2, physical therapy: nerve electrical stimulation therapy (muscle excitation therapy instrument, low-frequency pulse excitation electrical stimulation instrument meridian conductive frequency instrument, neuromuscular therapy instrument, etc.); thermal therapy; hydrotherapy; magnetic therapy, phototherapy, ultra-short wave, laser, biofeedback.
3.The application of orthopedic splints and braces.
3.Chinese medicine, Chinese medicine, massage, acupuncture treatment and acupuncture point injection.
4.Western medicine treatment (scopolamine, cytarabine, cerebral activator, antan, etc.).
5.Hyperbaric oxygen therapy.
Surgical treatment
Surgery is only one part of the comprehensive treatment for cerebral palsy, and it is necessary to select patients strictly and make a careful plan. Pre-operative and post-operative physical therapy are required. Generally speaking, children under the age of 1 year are not suitable for surgical treatment, and children under the age of 6 years are not easy to perform orthopedic surgery.
There are several methods of surgery as follows.
I. Surgery of the nervous system
1. Posterior spinal nerve root amputation: commonly used for severe spasticity of the extremities, with multiple muscles in spasm.
2.Pallidum destruction, commonly used in patients with reversed spasticity.
3.Fetal brain transplantation, neural stem cell transplantation.
4, peripheral nerve narrowing: commonly used for a part or the whole branch of the nerve innervating a responsible muscle spasm. The effect is clear and less invasive.
5.Carotid sympathetic nerve stripping, commonly used in patients with mental retardation, backward language development and salivation.
II. Surgery of muscles and tendons
1.Tendonotomy or tendon lengthening: tendon contracture is obvious, which can reduce its mechanical strong contraction and improve its muscle balance.
2.Tendon transposition: In some parts, transferring the muscle stop that aggravates the deformity to a new stop can change its function, that is, changing the force that aggravates the deformity to the power that corrects the deformity.
C. Bone and joint surgery
1.Bone lengthening or shortening surgery to correct the unequal length of lower limbs.
2.Osteotomy, including wedge osteotomy and rotary osteotomy to correct the deformity.
3.Joint fixation to fix the joint in a functional position to increase stability and improve function.