Abstract
Scoliosis is a common problem in cerebral palsy typified by rapid progression that often leads to large curve magnitudes even after skeletal maturity. The purpose of this study was to determine the relationship between curve progression and disease severity in cerebral palsy according to the Gross Motor Function Classification (GMFCS).
This retrospective study reviewed 34 children with a known diagnosis of cerebral palsy who were scheduled for or have already had surgical stabilization for scoliosis. Two patients (6%) were classified as GMFCS level III, 13 (38%) as GMFCS level IV, and 19 (56%) as GMFCS level V. There were no patients in GMFCS levels I or II.
Between the more severely involved children in GMFCS levels IV and V, there were no significant differences in curve magnitude at first presentation (means, 41.4 and 45.3 degrees, respectively; p=O.72), peak curve progression (28.2 degrees – interval 1.5 years, 31.4 degrees – interval 1. 75 years, respectively; p=O.35), or age at onset of peak curve progression (12.2 and 11.2 years, respectively). When adjusted for age at presentation, however, there was some indication of a difference in initial curve magnitude between GMFCS levels IV and V (least squares means, 35.7 and 49.2 degrees, respectively; p=O.10). The small number of patients in GMFCS level III precluded statistical analysis.
In this study, the nature of scoliosis in cerebral palsy was found to be related to functional level. Once scoliosis has been diagnosed, children in the higher GMFCS levels have an increased risk of rapid and unpredictable curve progression.
The abstracts were prepared by Editorial Secretary Jean-Claude Theis. Correspondence should be addressed to NZOA at Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.
