Texas Comprehensive Spasticity Center
Children with spasticity, movement disorders or cerebral palsy have complex care needs and typically see multiple providers for different opinions before their parents make a treatment decision. In the process they lose valuable time and, in many cases, suffer irreversible damage. Specialists affiliated with the Texas Comprehensive Spasticity Center aim to end the cycle of referral from specialist to specialist by offering carefully coordinated multidisciplinary care in a single location.
A collaboration of Children’s Memorial Hermann Hospital, the Memorial Hermann Mischer Neuroscience Institute at the Texas Medical Center and McGovern Medical School, the Texas Comprehensive Spasticity Center is led by Manish N. Shah, M.D., an assistant professor in the division of Pediatric Neurosurgery and director of pediatric spasticity and movement disorder surgery.
The team of affiliated physicians includes a pediatric neurologist who specializes in movement disorders, three pediatric neurosurgeons, pediatric orthopedists and a pediatric physical medicine and rehabilitation specialist, plus physical and occupational therapists, a clinical trial program manager and physician assistants and medical assistants who coordinate care. This multidisciplinary approach ensures the most comprehensive specialized treatment for each patient, beginning with evaluation – observation, videos and medical tests – and continuing through treatment and therapy.
“No other group of specialists in the region sees spasticity patients together for an hour in one room,” Dr. Shah says. “We all work together to determine in one session what the child needs, so that parents know exactly what the treatment options are before they leave the Center. This approach saves children years of bouncing from provider to provider with no real treatment decision made. They often need to be seen by three or four specialists. By the time they see all of these providers – and many have long scheduling wait times – the contracture has caused irreversible damage to their joints and muscles. They may need to see an orthopedic surgeon. If they do, we can refer them down the hall. If we determine that they need a new brace, we can refer them to occupational therapy. If a child is a candidate for selective dorsal rhizotomy, we can schedule the surgery and arrange a transfer to Shriners Hospital for Children for inpatient rehabilitation after discharge from acute care. We also ensure that parents have access to home therapy after their stay at Shriners.
“The process we’ve created fills an enormous care gap in the community and illustrates how much of a challenge it is for these parents to coordinate care for their children,” Dr. Shah says. “We all work very well together to ensure that patients are appropriately diagnosed and receive treatment in a timely fashion.”