Erica enters the motion analysis center (MAC) at Shriners Children’s Lexington with a smile so wide she can’t help but squint behind her royal blue glasses.
Using a walker, the bubbly 16-year-old makes her way into the MAC and readies for a gait analysis that will let her doctors and parents know how she’s doing after surgery. After gathering a number of measurements, a physical therapist affixes more than a dozen reflective markers on key points of Erica’s hips, legs, knees, ankles and feet.
Cameras situated around the large room pick up these markers and create a digital figure of Erica as she walks. Providers in the MAC will be able to gather a variety of data points from this figure and compare it to similar data collected before Erica had surgery. The goal is to determine if the surgeries – derotational tibial osteotomies performed in 2021 and 2022 – were successful in helping Erica walk without falling.
Before surgery, Erica’s feet were turned inward and dragged as she walked, tripping her and causing falls.
During the tibial osteotomies, Erica’s surgeon, Vincent Prusick, M.D., cut her tibias to allow them to rotate freely. He then realigned her tibias in a more optimal direction and fixed them in place using plates and screws.
Navigating Life With Cerebral Palsy
Erica has spastic diplegia, a form of cerebral palsy (CP). Cerebral palsy is caused by damage or abnormal development of the brain, and primarily impacts the parts of the brain that control movement.
“Cerebral palsy is a neurologic condition that presents along a spectrum,” Dr. Prusick said. “It can have relatively mild effects on some children or it can be more significant and affect a child’s ability to move in a coordinated fashion, and ability to do normal activities of daily living on their own. Orthopedically, this can manifest as difficulty with coordination and require bracing and physical therapy, or can lead to significant contractures of the joints requiring surgical intervention as well as affect the bony development of the hips or lead to scoliosis.”
Shriners Children’s locations worldwide treat thousands of children with cerebral palsy each year.
“We offer a wide variety of services for children affected by cerebral palsy, including orthotics, physical therapy, wheelchair services, medical management of spasticity, motion analysis lab to evaluate gait and upper extremity functioning, and a coordinated care team that includes therapists, nurses, advance practice providers and surgeons,” Dr. Prusick said.
In Erica’s case, cerebral palsy causes contractures in her lower extremities and some developmental delays.
We truly appreciate the eagerness to keep finding new things to help Erica. Shriners is always looking ahead ... and using this information to ask, ‘How can we advance her life through medicine?’
Connecting With Care
Erica was diagnosed with cerebral palsy when she was 4, while living in an overcrowded orphanage in China.
“Erica was found as a baby in front of a hospital in China, potentially on the day she was born,” said Eve, Erica's mom. “It is likely her CP was caused by lack of medical care at birth.”
Her parents, Eve and Jeremy, were open to the idea of adopting a child with special needs, and began looking at photos of children who needed a home. While flipping through the photo books, they came across Erica. “I knew immediately,” Eve recalled. “I saw the photo and said, ‘That’s my kid.’”
Sure enough, after months of trudging through the international adoption process, Erica came to the U.S. with her parents and older brother. Her parents took her to the International Adoption Center at University of Kentucky, which referred her to Shriners Children’s Lexington for the orthopedic care related to her cerebral palsy.
Her care at Shriners Children’s Lexington started with regular injections that helped relax the muscles in her lower extremities. “She took her first steps without a walker just two weeks after getting her first injections,” Eve said.
After that, Dr. Prusick and Susan McDowell, M.D., monitored Erica’s condition as she grew. She was wearing ankle foot orthoses (AFOs), but was still falling, so the doctors recommended surgery.
Walking With More Confidence
“The goal was to improve her foot positioning,” Dr. Prusick said. “Prior to surgery, Erica’s feet pointed inward significantly and caused her to trip. By performing tibial osteotomies we were able to position her feet in a straight-forward position to decrease the interference her feet were having on each other.”
“After the surgeries, her feet don’t drag as much and she has less risk of falling,” Eve added.
Dr. Prusick was also able to complete preliminary paperwork to get Erica approved to wear electric stimulation knee devices that send signals to target muscles that make her foot flex more appropriately while she walks.
“It’s amazing how much difference the devices have made,” Eve said.
Looking Ahead
While medical advances have been a critical part of Erica’s journey, her attitude is just as important. “Erica is joy personified,” Eve said. “She has an infectious joy. When she’s around someone, she makes them more joyful.”
Behind her ear-to-ear grin, Erica shared that she likes Legos and puzzles. She loves Grogu, a character from Disney’s The Mandalorian, often referred to as “Baby Yoda.” “Her whole room is Baby Yoda,” Eve said with a chuckle.
Erica enjoys playing basketball and baseball, and attending a worship service at her church designed specifically for individuals with special needs and their families.
For Eve and Jeremy, Shriners Children’s Lexington has been a safe place for the family to explore new options to make Erica’s life better. “We truly appreciate the eagerness to keep finding new things to help Erica,” Eve said. “Shriners is always looking ahead. Just like with this MAC study, they are measuring and using this information to ask, ‘How can we advance her life through medicine?’”
