Abstract
Children with cerebral palsy (CP) develop scoliosis as they go through adolescent growth. The most common group of children are those who are not able to walk and are labeled Gross Motor Function Classification System (GMFCS) IV–V. The scoliosis develops between the ages of 8 and 12 years old with progression during the adolescent growth. As the scoliosis curves become more severe, the deformity starts to cause problems with seating. Also as the curve continues to become more severe, it impacts pulmonary function and gastrointestinal motility and often causes pain. The pain develops mostly as the deformity becomes even more severe and the pelvis impinges on the inferior chest wall. Nonoperative treatment options are very limited as there is no evidence that the use of body bracing or orthotics makes an impact on either the magnitude of the scoliosis or the rate of progression of the scoliosis. These body braces or thoracolumbar spinal orthosis (TLSO) can be helpful to improve sitting posture and sitting balance. They should be used for the immediate functional benefit they provide. There is no indication for nighttime bracing, and the complications of the braces have to also be considered which include respiratory restrictions and abdominal restriction which may impact feeding tolerance and pulmonary clearance. Other nonoperative treatments such as physical therapy, postural support, electrical stimulation, and botulinum toxin type A have not demonstrated any benefit to prevent the progression of the deformity.
Similar content being viewed by others
References
Bohmer CJ, Klinkenberg-Knol EC, de Boer MC, Meuwissen SG (2000) Niezen- gastroesophageal reflux disease in intellectually disabled individuals: how often, how serious, how manageable? Am J Gastroenterol 95:1868–1872
Bunnell WP, MacEwen GD (1977) Non-operative treatment of scoliosis in cerebral palsy: preliminary report on the use of a plastic jacket. Dev Med Child Neurol 19:45–49
Edebol-Tysk K (1989) Epidemiology of spastic tetraplegic cerebral palsy in Sweden. I. Impairments and disabilities. Neuropediatrics 20:41–45
Lampe R, Blumenstein T, Turova V, Alves-Pinto A (2014) Lung vital capacity and oxygen saturation in adults with cerebral palsy. Patient Prefer Adherence 8:1691–1697
Langerak NG, Vaughan CL, Hoffman EB, Figaji AA, Fieggen AG, Peter JC (2009) Incidence of spinal abnormalities in patients with spastic diplegia 17 to 26 years after selective dorsal rhizotomy. Childs Nerv Syst 25:1593–1603
Lee SY, Chung CY, Lee KM, Kwon SS, Cho KJ, Park MS (2016) Annual changes in radiographic indices of the spine in cerebral palsy patients. Eur Spine J 25:679–686
Legg J, Davies E, Raich AL, Dettori JR, Sherry N (2014) Surgical correction of scoliosis in children with spastic quadriplegia: benefits, adverse effects, and patient selection. Evid Based Spine Care J 5:38–51
Leopando MT, Moussavi Z, Holbrow J, Chernick V, Pasterkamp H, Rempel G (1999) Effect of a soft Boston orthosis on pulmonary mechanics in severe cerebral palsy. Pediatr Pulmonol 28:53–58
Madigan RR, Wallace SL (1981) Scoliosis in the institutionalized cerebral palsy population. Spine 6:583–590
Majd ME, Muldowny DS, Holt RT (1997) Natural history of scoliosis in the institutionalized adult cerebral palsy population. Spine 22:1461–1466
Miller A, Temple T, Miller F (1996) Impact of orthoses on the rate of scoliosis progression in children with cerebral palsy [see comments]. J Pediatr Orthop 16:332–335
Persson-Bunke M, Hagglund G, Lauge-Pedersen H, Wagner P, Westbom L (2012) Scoliosis in a total population of children with cerebral palsy. Spine (Phila Pa 1976) 37:E708–E713
Saito N, Ebara S, Ohotsuka K, Kumeta H, Takaoka K (1998) Natural history of scoliosis in spastic cerebral palsy. Lancet 351:1687–1692
Terjesen T, Lange JE, Steen H (2000) Treatment of scoliosis with spinal bracing in quadriplegic cerebral palsy. Dev Med Child Neurol 42:448–454
Tsirikos AI, Mains E (2012) Surgical correction of spinal deformity in patients with cerebral palsy using pedicle screw instrumentation. J Spinal Disord Tech 25:401–408
Tsirikos AI, Chang WN, Dabney KW, Miller F, Glutting J (2003) Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion. Dev Med Child Neurol 45:677–682
Tsirikos AI, Chang WN, Dabney KW, Miller F (2004) Comparison of parents’ and caregivers’ satisfaction after spinal fusion in children with cerebral palsy. J Pediatr Orthop 24:54–58
Wong C, Pedersen SA, Kristensen BB, Gosvig K, Sonne-Holm S (2015) The effect of botulinum toxin a injections in the spine muscles for cerebral palsy scoliosis, examined in a prospective, randomized triple-blinded study. Spine (Phila Pa 1976) 40:E1205–E1211
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this entry
Cite this entry
Miller, F. (2019). Cerebral Palsy Spinal Deformity: Etiology, Natural History, and Nonoperative Management. In: Miller, F., Bachrach, S., Lennon, N., O'Neil, M. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-50592-3_107-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-50592-3_107-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-50592-3
Online ISBN: 978-3-319-50592-3
eBook Packages: Springer Reference MedicineReference Module Medicine