Erich Rutz1, Reinald Brunner1. 1. Pediatric Orthopaedic Department, University Children's Hospital Basel, UKBB, Basel, 4031 Switzerland.
Abstract
INTRODUCTION: The incidence of scoliosis in Cerebral Palsy (CP) is directly related to the Gross Motor Function Classification System (GMFCS) level. The natural history of untreated scoliosis in patients with CP is one of progression and factors implicated in deterioration include type of involvement (quadriplegia), poor functional status (nonambulatory, GMFCS levels IV and V), and curve location (thoracolumbar). The generally accepted incidence in the overall CP population is 20-25 %. MATERIALS AND METHODS: We recently published our short term results for 31 children treated with a short lumbar brace. In cases of a "positive hands up test" we recommend a short lumbar brace, and in patients with scoliosis with a Cobb angle >20° a double shelled brace. RESULTS: In our study, there was a correction of 37 % for the lumbar Cobb angle and 39 % for the thoracic Cobb angle at a mean follow-up of 28 months. CONCLUSION: The incidence of scoliosis in the overall CP population is 20-25 % and is directly related to the GMFCS level. Therefore, we recommend early treatment and prescribe a short lumbar brace in patients with dynamic instability of the trunk, and in scoliosis with a Cobb angle >20° a double shelled brace.
INTRODUCTION: The incidence of scoliosis in Cerebral Palsy (CP) is directly related to the Gross Motor Function Classification System (GMFCS) level. The natural history of untreated scoliosis in patients with CP is one of progression and factors implicated in deterioration include type of involvement (quadriplegia), poor functional status (nonambulatory, GMFCS levels IV and V), and curve location (thoracolumbar). The generally accepted incidence in the overall CP population is 20-25 %. MATERIALS AND METHODS: We recently published our short term results for 31 children treated with a short lumbar brace. In cases of a "positive hands up test" we recommend a short lumbar brace, and in patients with scoliosis with a Cobb angle >20° a double shelled brace. RESULTS: In our study, there was a correction of 37 % for the lumbar Cobb angle and 39 % for the thoracic Cobb angle at a mean follow-up of 28 months. CONCLUSION: The incidence of scoliosis in the overall CP population is 20-25 % and is directly related to the GMFCS level. Therefore, we recommend early treatment and prescribe a short lumbar brace in patients with dynamic instability of the trunk, and in scoliosis with a Cobb angle >20° a double shelled brace.
Authors: Kate L Willoughby; Soon Ghee Ang; Pam Thomason; Erich Rutz; Benjamin Shore; Aaron J Buckland; Michael B Johnson; H Kerr Graham Journal: J Paediatr Child Health Date: 2021-08-28 Impact factor: 1.929
Authors: Matthew Wheelwright; Paige J Selvey; Paul Steinbok; Ash Singhal; George Ibrahim; Aria Fallah; Alexander G Weil; Kyle Halvorson; Albert Tu Journal: Childs Nerv Syst Date: 2019-10-08 Impact factor: 1.475