Paralytic spinal deformity following traumatic spinal-cord injury in children and adolescents.

We attempted to evaluate the effect on the spinal column of loss of muscular support following trauma to the spinal cord during childhood. The cases of fifty patients, newborn to seventeen years old at the time of injury, were analyzed. Thirty-one patients had scoliotic curves of more than 20 degrees; twenty-one of these were long paralytic curves of 40 degrees or more. Age at injury was the single most important risk factor in the development of scoliosis; spasticity was also a very significant factor. Patients with lesions at all neural levels were at risk, while laminectomy was not a significant cause of scoliosis. On lateral roentgenograms the predominant finding was a reversal of the lumbar lordosis into a kyphosis, with the resultant development of a long thoracolumbar kyphosis. In five patients the opposite deformity, thoracolumbar lordosis, developed.