Multi-level surgery for cerebral palsy

SINGLE EVENT MULTI-LEVEL SURGERY (SEMLS)


Our orthopaedic consultants treat bone and tissue deformities in young cerebral palsy patients with multi-level surgery

Enquiries & Appointments

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What is multi-level surgery?

Multi-level surgery is a treatment option for children with cerebral palsy. Multiple orthopaedic procedures are carried out in one go, in order to reduce the number of procedures overall. It also reduces recovery and rehabilitation time.

The procedures are carried out after selective dorsal rhizotomy (which reduces spasticity) to help correct remaining bone and joint deformities in the feet, ankles, knees and hips. These include twisted thigh and shin bones and hip dysplasia, where the bone slides out of the socket. Soft tissue problems such as tight tendons are also addressed.

Multi-level surgery is carried out after extensive gait analysis. The consultant observes how your child walks and identifies specific issues they may have, to form a treatment plan.

These multiple procedures may help a child with cerebral palsy to walk better and improve mobility skills and joint mobility.

Need to know

Firstly your child will have extensive gait analysis with a consultant. They will observe how the child walks over a period of time, and may recommend multiple level surgery to address specific issues.

The procedures happen in one combined trip to the operating theatre. Your child will have a general anaesthetic and will be asleep throughout. Depending on your child's conditions, they will then undergo multiple treatments on their legs. These range from open reduction and hip reconstruction for hip dysplasia, to correcting foot deformities. Surgery time depends on the quantity and complexity of procedures.

Your consultant will explain the procedure and answer any questions you have. In the week before surgery, it’s important that your child stays healthy. Let your consultant know if your child has recently had a cold or a sore throat, as surgery may need to be postponed to reduce the risk of complications.

Because general anaesthetic is used during the procedure, your child may need to fast for several hours before the operation. Your consultant will tell you how long they should avoid eating and drinking. Like all procedures, there may be some risks and side effects. Your consultant will explain these to you.

Having multi-level surgery means one single, prolonged recovery involving physiotherapy. Your child will spend the first three weeks after surgery recovering from the procedures. After six weeks, your child will start extensive physiotherapy.

Once X-rays show adequate healing, the child will learn to move and bear weight on their limbs with the help of crutches. They will be encouraged to exercise two to three times a week, to increase strength. Your child should be fully recovered from multi-level surgery after a year. Your consultant will monitor their progress throughout.

{{EntityName}} Consultants

Mr Andrew Goldberg OBE

Mr Andrew Goldberg OBE

Orthopaedic Surgery

Mr Mazin Ibrahim

Mr Mazin Ibrahim

Orthopaedic Surgery

Mr Jonathan Wright

Mr Jonathan Wright

Orthopaedic Surgery

Mr Gregory Bodley Firth

Mr Gregory Bodley Firth

Orthopaedic Surgery

Our locations

The Portland Hospital

The Portland Hospital

205-209 Great Portland Street W1W 5AH London
The Shard Outpatients

The Shard Outpatients

The Shard, 32 St Thomas Street SE1 9BS London

Patient stories

This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.