Counterparalysis for treatment of paralytic scoliosis with botulinum toxin type A.

In this study, botulinum toxin was used to treat paralytic scoliosis. Twelve children with paralytic scoliosis and severe, complicating additional diseases required surgical delay. Although this use of botulinum toxin is experimental, alternative treatments posed greater risks. An institutional review board protocol for nonestablished dosage and indication for treatment was initiated to monitor safety and effect. Treatment was intended to supplement, not replace, other desirable treatment modalities. The effect was to be measured by the return of efficacy of conservative treatment in halting curve progression. Short-term results show that none of the children had worsened scoliosis; all had some reduction in curve measurement (up to >50 degrees).