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Treating Chronic Disabilities

Specialty Management Model

As our understanding of the human body and its illnesses increased in the 19th and 20th centuries, physicians began to specialize in order to better comprehend and exploit the increasingly complex and detailed knowledge of the different organ systems in the body. A person with a health issue will commonly seek relief by visiting their primary practitioner. After an assessment of the symptoms, the primary practitioner will frequently refer the patient to a specialist for further care. However, when multiple organ systems are involved, a single specialist or sub-specialist may not understand the relationships among the different organ systems involved well enough to effectively manage the patient’s condition. This is a particular risk for patients seeking management of their chronic disabilities, and suboptimal outcomes with associated complications can result.

Team Management Model

As increasing numbers of treatments became available to manage children and adults with cerebral palsy, a team management approach began to emerge. Orthopedists, neurosurgeons, physiatrists, and physiotherapists collaborated to manage abnormal muscle tone and the resulting complications, demonstrating improved outcomes for their patients. The physicians at Function have extensive experience with team management of cerebral palsy and have used it to model a similar approach for managing other chronic disabilities of the neuromuscular system. A broad range of classical and leading-edge therapies are assessed and applied, including:

Neurosurgical
  • Selective Dorsal Rhizotomy
  • Selective DREZotomy
  • Intrathecal Baclofen
  • Spinal Cord Detethering
  • Shunt Assessment and Repair
  • Nerve Reconstruction
  • Chiari malformations
  • Brain and spinal cord tumors
  • Minimally invasive endoscopic management of hydrocephalus
Orthopedic
  • Tendon lengthening and transfer
  • Osteotomy for angular and rotational deformity
  • Scoliosis correction with spinal fusion
Rehabilitation Medicine
  • Botulinum tox Injections for spasticity and drooling treatment
  • Phenol and Alcohol Injections
  • Infusion Pump (Baclofen) Management
  • Therapy, Physical and Occupational
  • Bracing and equipment evaluation
  • Nerve conduction and EMG testing
Urological
  • Urodynamic Studies
  • Cystoscopy
  • Appendicovesicostomy
  • Enterocystoplasty
  • Urethra Reconstruction
  • Urethroplasty
  • MACE Procedure
  • BOTOX Bladder

Contact Function: A Collaborative Program for Chronic Disability


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The Function Clinic is located in the Hutchinson Metro Center, in Towers 1 (1st Friday of the month) and Tower 2 (2nd and 4th Fridays of the month) with on-site access to Montefiore’s laboratory and radiology services.