Mumbai, May 23: An 11-year-old boy with spastic diplegic cerebral palsy has shown significant improvement in walking after undergoing a minimally invasive, single-session procedure at Narayana Health SRCC Children’s Hospital in Mumbai. The intervention was led by Dr Taral Nagda, Senior Consultant – Paediatric Orthopaedics at the hospital.
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Born prematurely at seven months and weighing 1.9 kg, Agastya had experienced delayed developmental milestones since infancy. Although his speech, hearing, and vision remained normal, walking had always been difficult. Over the years, regular physiotherapy helped him manage his condition, but during a recent growth phase, his mobility worsened.
Doctors identify worsening mobility condition
Doctors observed that he had developed a crouch gait, a condition in which the hips and knees remain bent while walking, making movement tiring and inefficient.
Further examination revealed adductor spasm and knee flexion contracture, which restricted his ability to straighten his knees fully. His earlier MRI findings of hypoxic ischemic encephalopathy confirmed spastic diplegic cerebral palsy.
According to specialists, growth spurts in children with cerebral palsy often lead to muscles becoming tighter as bones lengthen faster than the muscles can adapt. In Agastya’s case, physiotherapy alone was no longer sufficient.
The medical team decided on a combined minimally invasive approach involving botulinum toxin injections and ultrasound-guided percutaneous myofascial release.
During the one-hour procedure, 100 units of botulinum toxin were injected into the adductors and hamstrings to relax the tight muscles, followed by a suture-less release procedure under ultrasound guidance.
Minimally invasive treatment aids recovery
“The key is recognising the right window for intervention before these changes become permanent,” said Dr Nagda. “With this combined approach, we were able to improve joint movement and reduce the effort required for walking.”
The procedure involved negligible blood loss, minimal discomfort, and no surgical incision. After a three-day hospital stay, Agastya was discharged with a push knee splint to support recovery.
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