Management and treatment of musculoskeletal problems in adults with cerebral palsy: Experience gained from two lifespan clinics

The adult patient with CP faces a difficult situation with a lack of preventative or primary medical or surgical care. The impetus is on the providers, encouraging specialization and access to care through continuity clinics and consistent providers. Spine and hip pathology are a primary consideration. New loss of function or clinical deterioration should prompt screening for myelopathy or hydrocephalus as a cause. In the authors' experience, a SEMLS approach is safe with an expected prolonged rehabilitation course. Lever arm dysfunction is primarily addressed with femoral derotation or foot reconstructions. Foot deformities are the most common surgically addressed sites for adults withCP. It is critical that more research into the long-term outcomes of these surgeries, as well as a more systematic approach to the general and musculoskeletal assessment and treatment of adults with CP, should be the focus of future research.