What is SMELs:
Single-event multi-level surgery, also known as SEMLs, is a type of surgery which is mostly used for children with cerebral palsy. There are other conditions that might require this type or surgery, however the rates are not as common.
Why can Cerebral Palsy lead to Multi level surgery:
While the condition of cerebral palsy is static and does not worsen over time, the impact that it has on the body (bones and muscles) does. Children with cerebral palsy are at risk of significant changes to their musculoskeletal system, as their tight muscles cant keep up with the growing body. This may include things such as permanent shortening of muscles (known as contractures), deformity of joints and dislocations of the hip bones.
As a result over time children may have to undergo surgeries at multiple different parts of their body, typically from the hips down. Each time a child undergoes one of these surgeries, it has a significant impact on their life with hospital stays and needs for significant rehab and time away from school and daily life.
Benefit of SEMLs:
The aim of SEMLs is to address multiple joints in the legs – hips, knees and ankles in one big operation. The ultimate aim is to delay the need for surgery for as long as possible so there is no need for further surgery as your child grows For example, a child may have surgeries on their hips, knees and ankles all at once. The benefit of this strategy is the reduction of overall time they spend in hospital, and the amount of rehabilitation they must do, limiting the time they cannot participate in their social life and the impact it has on family life.
Treatment:
To ensure the best possible outcome for those surgeries, adequate care prior and after the event is essential.
This can include but is not limited to:
- Strength training
- Mobility and stretching program
- Functional training (for example gait training, stairs, etc…)
- Prescription and set up with the right equipment and assistive technology (for example splints, AFOs, standing frames, etc…)
- Pain management
- Carer education and training in handling, including transfers
Our physiotherapist team at Klint Kids can provide your family with the right strategies and treatment to ensure your child can continue to partake in the activities that they enjoy up to their multi level surgery and guide you through post-surgery rehabilitation.
Rehabilitation after significant surgery like this can take 1 year of support to see the best outcomes. We offer flexibility as your child’s needs change eg home visits, intensives in clinic, hydrotherapy and at the gym.
We are there to problem solve and talk to your treating team to make sure we can support you and your child to reach their full capacity.
