Mumbai 15th June 2026: Born prematurely at seven months, weighing just 1250 grams, she had spent her earliest days in the NICU for three months as her tiny body learned to stabilise and grow, but soon it was seen that she wasn’t following usual growth patterns for many parents, a child’s first steps are a moment of joy. For one family, however, their baby girl’s early steps were accompanied by worry.
Doctors in Mumbai successfully treated a three-year-old girl diagnosed with spastic diplegic cerebral palsy through a minimally invasive, single-session intervention and helped her move closer to a more natural way of walking. The procedure was led by Dr Taral Nagda, senior consultant – Paediatric Orthopaedics, at Narayana Health SRCC Children’s Hospital.
Her journey had been delicate from the very beginning. Born prematurely at seven months, weighing just 1250 grams, she had spent her earliest days in the NICU for three months as her tiny body learned to stabilise and grow. As she got older, there were small signs that things were not following the usual growth pattern. She reached her milestones a little later than expected, even walking independently, which she did at 16 months. Yet in so many other ways, she was thriving. Since her speech, hearing, and vision were completely normal, her walking pattern stood out more sharply. Her parents, who watched her closely, hoped it would settle as she grew up. But it didn’t.
Instead, they saw a clear pattern emerging—the child walked mostly on her toes, her feet rarely touching the ground fully. This equinus gait, as it is medically known, brought her to the hospital. On examination, there was tightness in her calf muscles (spasticity), but more on the left side. Further investigations were done to find out the reason. A brain MRI revealed periventricular leukomalacia patches, pointing to a hypoxic injury that had affected the areas of the brain responsible for controlling her legs. The diagnosis—spastic diplegic cerebral palsy—finally gave a name to what the child was experiencing.
By this time, she was already undergoing regular physiotherapy, a routine that many families of children with cerebral palsy become familiar with since diagnosis. But therapy alone may not be enough, especially during periods of rapid growth. The muscles, which are tight, struggle to keep up with growing bones and gradually pull the body into gait patterns that can become hard to reverse. Keeping this in mind, a team of doctors at the hospital planned a combination treatment with botulinum toxin injections to help relax the tight muscles, and USG-guided percutaneous myofascial release to physically release the tightness. During the procedure, 100 units of botulinum toxin were administered into the adductors, hamstrings, and calf muscles, followed by a suture-less release under ultrasound guidance. What stood out was how immediate the change was—the tightness eased, and the alignment of her foot improved right then, almost instantly.
The procedure itself was brief, lasting about an hour, and gentle on the child’s body—with no incision, minimal discomfort, and negligible blood loss. A below-knee cast was applied to maintain this correction, and after a short three-day hospital stay, she was ready to go home. Perhaps the most reassuring moment for her parents came when they saw the child start walking from the very next day after discharge, with support.
At this stage in life, the brain is still learning and adapting. By correcting the way her muscles and joints move, the intervention will help guide her brain towards more natural movement patterns, reducing the chances of long-term complications and giving her better mobility as she grows.
Explaining the case, Dr Nagda said, “In children with spastic diplegic cerebral palsy, the affected muscles often fail to keep pace with bone growth, leading to tightness and abnormal gait patterns like equinus gait. The key is to intervene at the right time, before these changes become permanent contractures and before the child’s brain adapts to an abnormal walking pattern. With a combination of botulinum toxin injections and USG-guided percutaneous myofascial release, we were able to correct the deformity in a single sitting, restore more natural movement, and support both the child’s physical development and emotional confidence.”
Sometimes, the smallest changes—like how a child places her feet on the ground—carry the biggest implications for her future. This case shows how timely intervention in cerebral palsy can gently change the trajectory, helping a child not just walk better, but grow with greater confidence, ease, and independence.
