a novel minimally invasive surgical treatment for children with cerebral palsy
WHAT IS SPML?
- Selective – refers to selected areas of tightness caused by spasticity.
- Percutaneous – an instrument developed for eye surgeries is used to make small (2-3mm) incisions in the areas of tightness/spasticity Percutaneous refers to a procedure perfomed through skin using a needle etc.
- Myofascial – myo means muscle and fascia is defined as connective tissue made of collagen that covers a muscle or a group of muscles.
- Lengthening
Roy Nuzzo MD, a Pediatric Orthopaedic Surgeon based in Summit, NJ, USA, used this term to describe the surgical procedure that he invented to improve the function of children with cerebral palsy.
HOW SPML IS DONE?
This is a 5 ½ years old young guy with spastic quadriplegia. The Before video was taken at the gait lab. He underwent SPML and Alcohol Block on his lower extremities. Post operative videos were shot at six and eight months.
Alcohol Block
Case before & after Alcohol Block
This video shows that before the Alcohol Block when you try to move one leg, the other follows to the same direction. After the Alcohol Block each leg can be moved independently without cross reaction. This allows for voluntary muscle control (the child can move each leg without scissoring).
PERSONAL EXPERIENCE WITH SPML
Back in 2002, we had the opportunity to visit Dr Roy Nuzzo in his institution in Summit , NJ, where he kindly introduced us into his approach on treating patients with Cerebral Palsy. We had the chance to extensively discuss about patients but also to participate in SPML surgeries with him.
That was the beginning of a continuous scientific collaboration over the years that was enhanced by Dr David Yngve who also was following the same SPML approach in Galveston, TX ,USA
SPML IN GREECE
Later on, pre and post operative gait analysis was utilized to collect measurable data. That enable our group to contribute to the medical literature.The effort is still ongoing to Drs Nuzzo’s and Yngve’s applauses.
KIDS2WALK
HOW TO REACH US
- Day 1: It includes pre operative gait analysis, physical therapy evaluation as well as pediatric orthopedic evaluation
- Day 2: Hospital admission, surgery, postoperative physical therapy, hospital discharge.
- Day 3: Post operative physical therapy at the rehabilitation center, pediatric orthopedic consultation
Visit the rehabilitation center ENA for more information.
OUR HOSPITAL
Pre-operative assessment and surgery take place at
Iaso Children’s Hospital, in Athens ,Greece.
SCIENCE BEHIND SPML
Improving gait and lower-limb muscle strength in children with cerebral palsy following SPML & Functional Physiotherapy
BACKGROUND: Selective Percutaneous Myofascial Lengthening (SPML) is an innovative…
The effectiveness of functional approach in gross motor function of children with cerebral palsy
The effectiveness of functional approach in gross motor function of children with cerebral palsy: systematic review and meta-analysis…
Health-related quality of life following SPML
Health-related quality of life following selective percutaneous myofascial lengthening and functional physiotherapy in children with cerebral palsy…