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Muscular and neuromuscular conditions

Muscular and neuromuscular conditions

Neuromuscular conditions are often complex and varying in degrees of severity. For conditions like cerebral palsy and spina bifida, treatment involves more than just orthopaedic care. The Canada Shriners Hospital is committed to providing full-service care to children in multidisciplinary clinics that may include the expertise of neurosurgeons, urologists, physiotherapists, occupational therapists and other health care professionals.

More about the muscular and neuromuscular conditions we treat

Cerebral palsy

Cerebral palsy is a condition affecting muscle tone, movement and coordination. It is the most common disability that occurs before, during or immediately after birth and is related to a lack of oxygen to the brain. Learn more about how our team cares for children with cerebral palsy.

Nerve, muscular and connective tissue disorders

Arthogryposis is a group of disorders characterized by multiple joint contractures, muscle atrophy and muscle shortening present at birth. Most individuals with arthrogryposis have normal or above normal intelligence and normal sensation. The contractures are usually most severe at birth. The goals of treatment are to improve the function of these children specifically regarding mobility, self-care and daily activities, and to render them as independent as possible. Treatment should start immediately after birth and includes intensive physiotherapy and bracing for both upper and lower limb deformities. Learn more.

Charcot-Marie-Tooth is a group of disorders that affect the peripheral nerves that carry messages between the brain and muscles throughout the body. Treatment may include physical and occupational therapy, braces or splints. Surgery may be necessary for severe foot deformities and in some cases, for hip dysplasia.

Congenital pseudarthrosis of the tibia is one of the most challenging conditions to treat and is characterized by a persistent break in the bone, which is resistant to healing. Almost half the children seen with this condition have neurofibromatosis type 1. The presenting factors include a recalcitrant pseudarthrosis of the tibia, a limb deformity and length discrepancy. The challenge is not only to obtain union of the two parts of the tibia, but to maintain union and prevent deformities. Very often, children require multiple surgeries to obtain the best possible results.

Dermatomyositis is a rare autoimmune disorder that inflames healthy muscle tissue causing weakness. Common treatment may include physical therapy, speech therapy, medication and surgery.

Ehlers-Danlos syndrome is a group of inherited disorders that weaken connective tissues leading to ligamentous hyperlaxity. Treatment may include medication and physical therapy. Although it is rarely necessary, surgery may be included in treatment of Ehlers-Danlos syndrome.

Friedreich ataxia is a rare inherited disease that causes nervous system damage and movement problems. It usually begins in childhood and leads to impaired muscle coordination (ataxia) that worsens over time. The disorder is named after Nicholaus Friedreich, a German doctor who first described the condition in the 1860s. In Friedreich’s ataxia, the spinal cord and peripheral nerves degenerate, becoming thinner. The cerebellum, part of the brain that coordinates balance and movement, also degenerates to a lesser extent. This damage results in awkward, unsteady movements and impaired sensory functions. The disorder also causes problems in the heart and spine, and some people with the condition develop diabetes. The first symptom to appear is usually gait ataxia, or difficulty walking. The ataxia gradually worsens and slowly spreads to the arms and the trunk. There is a high incidence of this disorder in the province of Quebec. Surgery may often be required for correction of spinal deformities.

Marfan syndrome is a rare genetic disorder that affects the connective tissues. Abnormalities in the connective tissues in these children will present themselves with the child having an abnormal enlargement of the aortic root of the heart; dislocated lenses of the eyes; and a tall, lanky body with increased joint mobility; scoliosis; long, flat feet and long fingers. These conditions may vary among individuals diagnosed with this condition, even within a family. Many of them will require surgery for the correction of spinal deformities.

Muscular dystrophy is a genetic and progressive disease that causes muscle fibers to weaken and be replaced by abnormal tissue. Common treatments include physical therapy, medication and bracing of the limbs. Mobility aids such as a cane, walker or wheelchair may be needed. Surgery may be necessary for contractures and scoliosis.

Spina bifida, also known as myelomeningocele, is a congenital defect of the spine where the spinal cord and its meninges are exposed through a gap in the backbone. The initial care to address the exposed spinal cord and fluid on the brain is provided by a neurosurgeon at or near the time of birth. Orthopaedic evaluation and treatment for children with spina bifida begins after the neurosurgical intervention. Orthopaedic treatment for spina bifida includes physical therapy and occupational therapy, crutches and/or custom orthoses (braces) made in-house. At Shriners Hospitals for Children — Canada, we practice a multidisciplinary team approach, including assistive technology and rehabilitation care, neurology, orthopaedics, orthotics (bracing) and urology services. All services are conveniently provided during the specialty clinic held once a month so that families can see all specialists in one visit. Learn more about spina bifida treatment.

Spinal muscular atrophy is a group of disorders of the motor cells in the spinal cord and lower brainstem, which lead to muscle weakness and atrophy. This condition is typically inherited. Treatment for spinal muscular atrophy may include physical therapy, respiratory care, splints, spinal orthoses or surgery.

Tethered spinal cord is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord in the spinal column. This condition is often seen in conjunction with spina bifida. Treatment for this condition is surgery.

To make an appointment:

New patients:
Phone: 514-282-6971
Fax: 514-282-7221

Current patients:
Phone: 514-842-4464, ext. 6986