Skip to main content
SpringerLink
Log in

Scoliosis in Cerebral Palsy

  • Chapter
  • First Online:
Paediatric Scoliosis

  • 242 Accesses

Abstract

Cerebral palsy (CP) is a common nonprogressive motor impairment syndrome that is subsequent to lesions or abnormalities of the upper motor nervous system that occur in the early perinatal period and affects approximately 2–2.5 children per 1000 live births worldwide [1]. It is described by the type of motor disorder into spastic, ataxic, dystonic, and dyskinetic variants. Based on regional body involvement, it is described as hemiplegia, diplegia, and tetraplegia. Objectively, it is graded into five different classes (Levels I–V) based on the gross motor function classification system (GMFCS) [2, 3]. The presence of spinal deformity in CP has been reported to range between 20 and 25%, 5% of which is seen in spastic diplegia and 74% in spastic quadriplegia. This indicates that the incidence is directly related to the degree of neurological impairment as well as the GMFCS level of the child [4–7].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Teli MGA, Cinnella P, Vincitorio F, Lovi A, Grava G, Brayda-Bruno M. Spinal fusion with Cotrel-Dubousset instrumentation for neuropathic scoliosis in patients with cerebral palsy. Spine (Phila Pa 1976). 2006;31(14):441–7.

    Article  Google Scholar 

  2. WHO. World report on child injury prevention [Internet]. Geneva: World Health Organization; 2001. https://apps.who.int/iris/bitstream/handle/10665/42407/9241545429.pdf.

  3. Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised gross motor function classification system. Dev Med Child Neurol. 2008;50:744–50.

    Article  PubMed  Google Scholar 

  4. Tsirikos AI. Development and treatment of spinal deformity in patients with cerebral palsy. Indian J Orthop. 2010;44(2):148–58.

    Article  PubMed Central  Google Scholar 

  5. Saito N, Ebara S, Ohotsuka K, Kumeta H, Takaoka K. Natural history of scoliosis in spastic cerebral palsy. Lancet. 1998;351(9117):1687–92.

    Article  CAS  PubMed  Google Scholar 

  6. Majd ME, Muldowny DS, Holt RT. Natural history of scoliosis in the institutionalized adult cerebral palsy population. Spine (Phila Pa 1976). 1997;22:1461–6.

    Article  CAS  PubMed  Google Scholar 

  7. Loeters MJB, Maathuis CGB, Hadders-Algra M. Risk factors for emergence and progression of scoliosis in children with severe cerebral palsy: a systematic review. Dev Med Child Neurol. 2010;52(7):605–11.

    Article  PubMed  Google Scholar 

  8. Robson P. The prevalence of scoliosis in adolescents and young adults with cerebral palsy. Dev Med Child Neurol. 1968;10(4):447–52.

    Article  CAS  PubMed  Google Scholar 

  9. Kalen V, Conklin MM, Sherman FC. Untreated scoliosis in severe cerebral palsy. J Pediatr Orthop. 1992;12:337–40. Robert R Madigan scoliosis in institutionalized CPpopulation.pdf.

    Article  CAS  PubMed  Google Scholar 

  10. Porter D, Michael S, Kirkwood C. Is there a relationship between preferred posture and positioning in early life and the direction of subsequent asymmetrical postural deformity in non-ambulant people with cerebral palsy? Child Care Health Dev. 2008;34(5):635–41.

    Article  PubMed  Google Scholar 

  11. Thometz JG, Simon SR. Progression of scoliosis after skeletal maturity in institutionalized adults who have cerebral palsy. J Bone Joint Surg Am. 1988;70(9):1290–6.

    Article  CAS  PubMed  Google Scholar 

  12. Comstock CP, Leach J, Wenger DR. Scoliosis in total-body-involvement cerebral palsy: analysis of surgical treatment and patient and caregiver satisfaction. Spine (Phila Pa 1976). 1998;23:1412–25.

    Article  CAS  PubMed  Google Scholar 

  13. Letts M, Shapiro L, Mulder K, et al. The windblown hip syndrome in total body cerebral palsy. J Pediatr Orthop. 1984;4:55–62.

    Article  CAS  PubMed  Google Scholar 

  14. Senaran H, Shah SA, Presedo A, Dabney KW, Glutting JW, Miller F. The risk of progression of scoliosis in cerebral palsy patients after intrathecal baclofen therapy. Spine (Phila Pa 1976). 2007;32(21):2348–54.

    Article  PubMed  Google Scholar 

  15. Porter D, Michael S, Kirkwood C. Patterns of postural deformity in nonambulant people with cerebral, palsy: what is the relationship between the direction of scoliosis, direction of pelvic obliquity, direction of windswept hip deformity and side of hip dislocation? Clin Rehabil. 2007;21(12):1087–96.

    Article  PubMed  Google Scholar 

  16. Vialle R, Thévenin-Lemoine C, Mary P. Neuromuscular scoliosis. Orthop Traumatol Surg Res [Internet]. 2013;99(1):S124–S139. https://doi.org/10.1016/j.otsr.2012.11.002.

  17. Lonstein JE, Akbarnia BA. Operative treatment of spinal deformities in patients with cerebral palsy or mental retardation. An analysis of one hundred and seven cases. J Bone Joint Surg Am. 1983;65(1):43–55.

    Article  CAS  PubMed  Google Scholar 

  18. Holmes KJ, Michael SM, Thorpe SL, Solomonidis SE. Management of scoliosis with special seating for the nonambulant spastic cerebral palsy population—a biomechanical study. Clin Biomech. 2003;18(6):480–7.

    Article  CAS  Google Scholar 

  19. Bunnell WP, MacEwen GD. Non-operative treatment of scoliosis in cerebral palsy: preliminary report on the use of a plastic jacket. Dev Med Child Neurol. 1977;19(1):45–9.

    Article  CAS  PubMed  Google Scholar 

  20. Mercado E, Alman B, Wright JG. Does spinal fusion influence quality of life in neuromuscular scoliosis? Spine (Phila Pa 1976). 2007;32(19 Suppl):120–5.

    Article  Google Scholar 

  21. Askin GN, Hallett R, Hare N, Webb JK. The outcome of scoliosis surgery in the severely physically handicapped child. Spine (Phila Pa 1976). 1997;22:44–50.

    Article  CAS  PubMed  Google Scholar 

  22. McCarthy RE. Management of neuromuscular scoliosis. Orthop Clin North Am. 1999;30(3):435–49.

    Article  CAS  PubMed  Google Scholar 

  23. Anderson PR, Puno MR, Lovell SL, Swayze CR. Postoperative respiratory complications in non-idiopathic scoliosis. Acta Anesthesiol Scand. 1985;29(2):186–92.

    Article  CAS  Google Scholar 

  24. Boel L, Pernet K, Toussaint M, Ides K, Leemans G, Haan J, et al. Respiratory morbidity in children with cerebral palsy: an overview. Dev Med Child Neurol. 2019;61(6):646–53.

    Article  PubMed  Google Scholar 

  25. Almenrader N, Patel D. Spinal fusion surgery in children with nonidiopathic scoliosis: is there a need for routine postoperative ventilation? Br J Anaesth. 2006;97(6):851–7.

    Article  CAS  PubMed  Google Scholar 

  26. Khirani S, Bersanini C, Aubertin G, Bachy M, Vialle R, Fauroux B. Noninvasive positive pressure ventilation to facilitate the postoperative respiratory outcome of spine surgery in neuromuscular children. Eur Spine J. 2014;23(Suppl. 4):406.

    Article  Google Scholar 

  27. Jevsevar DS, Karlin LI. The relationship between preoperative nutritional status and complications after an operation for scoliosis in patients who have cerebral palsy. J Bone Joint Surg Am. 1993;75(6):880–4.

    Article  CAS  PubMed  Google Scholar 

  28. Farhat G, Yamout B, Mikati MA, Demirjian S, Sawaya R, El-Hajj FG. Effect of antiepileptic drugs on bone density in ambulatory patients. Neurology. 2002;58(9):1348–53.

    Article  CAS  PubMed  Google Scholar 

  29. Allarakhia IN, Garofalo EA, Komarynski MA, Robertson PL. Valproic acid and thrombocytopenia in children: a case–controlled retrospective study. Pediatr Neurol. 1996;14(4):303–7.

    Article  CAS  PubMed  Google Scholar 

  30. Tubaki VR, Rajasekaran S, Shetty AP. Effects of using intravenous antibiotic only versus local intrawound vancomycin antibiotic powder application in addition to intravenous antibiotics on postoperative infection in spine surgery in 907 patients. Spine (Phila Pa 1976). 2013;38(25):2149–55.

    Article  PubMed  Google Scholar 

  31. Luque E. The anatomic basis and development of segmental spinal instrumentation. Spine (Phila Pa 1976). 1982;7:256–9.

    Article  CAS  PubMed  Google Scholar 

  32. Sullivan JA, Conner SB. Comparison of Harrington instrumentation and segmental spinal instrumentation in the management of neuromuscular spinal deformity. Spine (Phila Pa 1976). 1982;7:299–304.

    Article  CAS  PubMed  Google Scholar 

  33. Luque ER. Segmental spinal instrumentation for correction of scoliosis. Clin Orthop Relat Res. 1982;163(1):192–8.

    Google Scholar 

  34. Allen BL Jr, Ferguson RL. The Galveston technique for L rod instrumentation of the scoliotic spine. Spine (Phila Pa 1976). 1982;7(3):276–84.

    Article  PubMed  Google Scholar 

  35. Dias RC, Miller F, Dabney K, Lipton GE. Revision spine surgery in children with cerebral palsy. J Spinal Disord. 1997;10(2):132–44.

    Article  CAS  PubMed  Google Scholar 

  36. Tsirikos AI, Mains E. Surgical correction of spinal deformity in patients with cerebral palsy using pedicle screw instrumentation. J Spinal Disord Tech. 2012;25(7):401–8.

    Article  PubMed  Google Scholar 

  37. Modi HN, Hong JY, Mehta SS, Srinivasalu S, Suh SW, Yi JW, et al. Surgical correction and fusion using posterior-only pedicle screw construct for neuropathic scoliosis in patients with cerebral palsy: a three-year follow-up study. Spine (Phila Pa 1976). 2009;34(11):1167–75.

    Article  PubMed  Google Scholar 

  38. Bell DF, Moseley CF, Koreska J. Unit rod segmental spinal instrumentation in the management of patients with progressive neuromuscular spinal deformity. Spine (Phila Pa 1976). 1989;14:1301–7.

    Article  CAS  PubMed  Google Scholar 

  39. Auerbach JD, Spiegel DA, Zgonis MH, Reddy SC, Drummond DS, Dormans JP, et al. The correction of pelvic obliquity in patients with cerebral palsy and neuromuscular scoliosis. Spine (Phila Pa 1976). 2009;34(21):E766–74.

    Article  PubMed  Google Scholar 

  40. Helenius IJ, Viehweger E, Castelein RM. Cerebral palsy with dislocated hip and scoliosis: what to deal with first? J Child Orthop. 2020;14(1):24–9.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. St. John’s Medical College and Hospital Pvt. Ltd, Bangalore, India

    N. V. Ankith

  2. Manipal Hospital, Bangalore, India

    Amritlal A. Mascarenhas

Authors
  1. N. V. Ankith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amritlal A. Mascarenhas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. V. Ankith .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics, Government Medical College, Kozhikode, Kerala, India

    Balaji Zacharia

  2. Department of Orthopaedic and Spine, Kauvery Hospital, Chennai, Tamil Nadu, India

    S. Dilip Chand Raja

  3. Department of Spine Surgery, Meitra Hospital, Kozhikode, Kerala, India

    Nikhil KV

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ankith, N.V., Mascarenhas, A.A. (2023). Scoliosis in Cerebral Palsy. In: Zacharia, B., Raja, S.D.C., KV, N. (eds) Paediatric Scoliosis . Springer, Singapore. https://doi.org/10.1007/978-981-99-3017-3_33

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-3017-3_33

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-3016-6

  • Online ISBN: 978-981-99-3017-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation