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pelvic obliquity cerebral palsy

Oussama Abousamra, Tristan Nishnianidze, Kenneth J Rogers, Ilhan A Bayhan, Petya Yorgova, Suken A Shah
STUDY DESIGN: Single institution cohort data were collected prospectively and reviewed retrospectively. OBJECTIVES: This study aims to compare outcomes among three different instrumentation types: unit rod, iliac screws, and sacral alar iliac (SAI) screws in terms of pelvic obliquity correction in children with cerebral palsy (CP). SUMMARY OF BACKGROUND DATA: The optimal choice for spinopelvic fixation in CP scoliosis with pelvic obliquity is controversial...
May 2016: Spine Deformity
Omar A Galarraga C, Vincent Vigneron, Bernadette Dorizzi, Néjib Khouri, Eric Desailly
In this work, postoperative lower limb kinematics are predicted with respect to preoperative kinematics, physical examination and surgery data. Data of 115 children with cerebral palsy that have undergone single-event multilevel surgery were considered. Preoperative data dimension was reduced utilizing principal component analysis. Then, multiple linear regressions with 80% confidence intervals were performed between postoperative kinematics and bilateral preoperative kinematics, 36 physical examination variables and combinations of 9 different surgical procedures...
November 9, 2016: Gait & Posture
Amit Jain, Paul D Sponseller, Suken A Shah, Amer Samdani, Patrick J Cahill, Burt Yaszay, Dolores B Njoku, Mark F Abel, Peter O Newton, Michelle C Marks, Unni G Narayanan
BACKGROUND: The Gross Motor Function Classification System (GMFCS) of cerebral palsy categorizes patients by mobility. Patients at GMFCS level 5 are considered the most disabled and at high risk of hip and spine problems, yet they represent a wide spectrum of function. Our aim was to subclassify patients at GMFCS level 5 who underwent spinal arthrodesis on the basis of central neuromotor impairments and to assess whether subclassification predicted postoperative complications and changes in health-related quality of life...
November 2, 2016: Journal of Bone and Joint Surgery. American Volume
Jae Young Park, Young Choi, Byung Chae Cho, Sang Young Moon, Chin Youb Chung, Kyoung Min Lee, Ki Hyuk Sung, Soon-Sun Kwon, Moon Seok Park
Progression of hip displacement is common in patients with cerebral palsy (CP). We aimed to investigate the rate of progression of hip displacement in patients with CP by assessing changes in radiographic indices according to Gross Motor Function Classification System (GMFCS) level during hip surveillance. We analyzed the medical records of patients with CP aged < 20 years who underwent at least 6 months interval of serial hip radiographs before any surgical hip intervention, including reconstructive surgery...
July 2016: Journal of Korean Medical Science
Prakash Sitoula, Laurens Holmes, Julieanne Sees, Kenneth Rogers, Kirk Dabney, Freeman Miller
STUDY DESIGN: Retrospective review of radiographs and charts (case-only). OBJECTIVE: The aim of this study was to describe the long-term outcomes of spine fusion for neuromuscular scoliosis in children <10 years of age with cerebral palsy (CP). SUMMARY OF BACKGROUND DATA: Severely involved children with CP may develop early onset scoliosis. The outcome of spine fusion is not clear and there are no studies focused on spine fusion in this young patient population...
June 20, 2016: Clinical Spine Surgery
Burt Yaszay, Paul D Sponseller, Suken A Shah, Jahangir Asghar, Firoz Miyanji, Amer F Samdani, Carrie Bartley, Peter O Newton
BACKGROUND: In juveniles with progressive curves, there is debate regarding the use of growth friendly implants versus definitive fusion. This study presents outcomes of juvenile cerebral palsy (CP) scoliosis patients who underwent definitive fusion before age 11. METHODS: A review of a prospective, multicenter registry identified patients 10 years and younger who had a definitive posterior fusion for their CP scoliosis. Preoperative and postoperative demographic and radiographic changes were evaluated with descriptive statistics...
June 2, 2016: Journal of Pediatric Orthopedics
Ismail Salk, Ali Cetin, Sultan Salk, Meral Cetin
BACKGROUND: We assessed retrospectively the reference values of pelvic dimensions by 3D CT performed for non-obstetrical indications in non-pregnant multiparous women with a successful vaginal delivery. We further aimed to evaluate the impact of maternal short stature on these parameters. MATERIAL/METHODS: The 3D CT pelvimetry was performed retrospectively in 203 non-pregnant women selected consecutively if they had at least one singleton term delivery with head presentation and if there was no history of maternal or fetal birth trauma or cerebral palsy after childbirth...
2016: Polish Journal of Radiology
Paul R P Rushton, Luigi A Nasto, Ranjit K Aujla, Amr Ammar, Michael P Grevitt, Michael H Vloeberghs
PURPOSE: To compare scoliosis progression in quadriplegic spastic cerebral palsy with and without intrathecal baclofen (ITB) pumps. METHODS: A retrospective matched cohort study was conducted. Patients with quadriplegic spastic cerebral palsy, GMFCS level 5, treated with ITB pumps with follow-up >1 year were matched to comparable cases by age and baseline Cobb angle without ITB pumps. Annual and peak coronal curve progression, pelvic obliquity progression and need for spinal fusion were compared...
May 6, 2016: European Spine Journal
Ailish Malone, Damien Kiernan, Helen French, Valerie Saunders, Timothy O'Brien
BACKGROUND: Balance problems are common in children who have cerebral palsy (CP) but are active and ambulant. Control of the whole-body center of mass is critical in maintaining dynamic stability during challenging mobility tasks, such as clearing an obstacle while walking. OBJECTIVE: The objective of this study was to compare trunk and lower limb kinematics and center-of-mass control in children with CP and those in children with typical development during obstacle crossing...
August 2016: Physical Therapy
Mathew David Sewell, Charlie Wallace, Francesc Malagelada, Alex Gibson, Hilali Noordeen, Stewart Tucker, Sean Molloy, Jan Lehovsky
Spinal fusion is used to treat scoliosis in children with cerebral palsy (CP). Following intervention, the WHO considers activity and participation should be assessed to guide intervention and assess the effects. This study assesses whether spinal fusion for scoliosis improves activity and participation for children with severe CP.Retrospective cohort study of 70 children (39M:31F) with GMFCS level 4/5 CP and significant scoliosis. Thirty-six underwent observational and/or brace treatment as the sole treatment for their scoliosis, and 34 underwent surgery...
December 2015: Medicine (Baltimore)
Lindsay Crawford, Jose Herrera-Soto, John A Ruder, Jonathan Phillips, Raymond Knapp
BACKGROUND: The goals of treatment of neuromuscular scoliosis are to achieve a balanced spine and level pelvis with most constructs including pelvic fixation. However, the pelvis can become a stiff "end vertebra" that prevents compensatory mechanisms to adjust to hip deformities in this patient population. The purpose of this study is to determine the frequency of hip pathology and surgery after spinal fusion in this patient population. METHODS: We performed a retrospective chart and radiographic review of cerebral palsy patients who underwent posterior spinal fusion (PSF) at our institution from 2005 to 2011...
December 2, 2015: Journal of Pediatric Orthopedics
Hyung Ik Shin, Ki Hyuk Sung, Chin Youb Chung, Kyoung Min Lee, Seung Yeol Lee, In Hyeok Lee, Moon Seok Park
PURPOSE: This study investigated the correlation between isometric muscle strength, gross motor function, and gait parameters in patients with spastic cerebral palsy and to find which muscle groups play an important role for gait pattern in a flexed knee gait. MATERIALS AND METHODS: Twenty-four ambulatory patients (mean age, 10.0 years) with spastic cerebral palsy who were scheduled for single event multilevel surgery, including distal hamstring lengthening, were included...
January 2016: Yonsei Medical Journal
C Heidt, K Hollander, J Wawrzuta, C Molesworth, K Willoughby, P Thomason, A Khot, H K Graham
Pelvic obliquity is a common finding in adolescents with cerebral palsy, however, there is little agreement on its measurement or relationship with hip development at different gross motor function classification system (GMFCS) levels. The purpose of this investigation was to study these issues in a large, population-based cohort of adolescents with cerebral palsy at transition into adult services. The cohort were a subset of a three year birth cohort (n = 98, 65M: 33F, with a mean age of 18.8 years (14.8 to 23...
October 2015: Bone & Joint Journal
Janki Patel, Frederic Shapiro
BACKGROUND: A triad of deformities-thoracolumbar scoliosis, pelvic obliquity, and femoral head (hip) subluxation/dislocation-occurs frequently in non-ambulatory neuromuscular patients, but their close inter-relationship is infrequently appreciated or quantified. We propose a deformity documentation approach to assess each component simultaneously. METHODS: The documentation assesses each component for maximal functional level, deformity, and flexibility/rigidity: deformity from antero-posterior radiographs (scoliosis-maximal functional position, pelvic obliquity-sitting, hip position-supine) and flexibility/rigidity from extent of repositioning on supine (spine, pelvis) and frog lateral (hip) radiographs...
October 2015: Journal of Children's Orthopaedics
Shawn Funk, Steven Lovejoy, Gregory Mencio, Jeffrey Martus
STUDY DESIGN: Retrospective chart and radiographic review. OBJECTIVE: To evaluate spinopelvic fixation technical advancements for the treatment of neuromuscular scoliosis. SUMMARY OF BACKGROUND DATA: Implants for vertebral and pelvic fixation have evolved without data demonstrating the benefit for neuromuscular scoliosis. The aim of this study was to evaluate this evolution in terms of deformity correction, complications, and implant cost...
January 2016: Spine
Arnaud Dubory, Manon Bachy, Houssam Bouloussa, Aurélien Courvoisier, Baptiste Morel, Raphaël Vialle
PURPOSE: The primary goal of curve correction in neuromuscular patients is to restore coronal and sagittal trunk balance, including the pelvis, to maximize sitting balance. For several years, it has been a common practice to inject polymeric cement into osteoporotic bone through specially designed, perforated pedicle screws in an effort to enhance screw stability. Therefore, we started using the association of a spinopelvic fixation with S1 pedicle screw augmentation, using bisphenol-a-glycidyl dimethacrylate composite resin in neuromuscular patients with pelvic obliquity, technique in neuromuscular patients to improve pedicle screw stability of our pelvic construct...
November 2015: European Spine Journal
Jaysson T Brooks, Paul D Sponseller
BACKGROUND: Patients with neuromuscular scoliosis (NMS) can pose treatment challenges related to medical comorbidities and altered spinopelvic anatomy. We reviewed the recent literature regarding evaluation and management of NMS patients and explored areas where further research is needed. METHODS: We searched the PubMed database for all papers related to the treatment of NMS published from January 1, 2011 through July 31, 2014, yielding 70 papers. RESULTS: A total of 39 papers contributed compelling new findings...
September 2016: Journal of Pediatric Orthopedics
Mathew D Sewell, Francesc Malagelada, Charlie Wallace, Alex Gibson, Hilali Noordeen, Stewart Tucker, Sean Molloy, Jan Lehovsky
BACKGROUND: Scoliosis affects 50% of children with Gross Motor Function Classification System (GMFCS) level IV or V cerebral palsy (CP). In children with complex neurodisability following intervention, the WHO considers quality of life (QoL) should be assessed to aid decision-making and assess the effects. This study assesses whether scoliosis surgery improves carer-assessed QoL for children with severe CP. METHODS: Retrospective review of 33 children (16 male:17 female) with GMFCS level IV/V CP and significant scoliosis...
April 2016: Journal of Pediatric Orthopedics
Meredith Wynter, Noula Gibson, Kate L Willoughby, Sarah Love, Megan Kentish, Pam Thomason, H Kerr Graham
AIM: To ensure hip surveillance guidelines reflect current evidence of factors influencing hip displacement in children with cerebral palsy (CP). METHOD: A three-step review process was undertaken: (1) systematic literature review, (2) analysis of hip surveillance databases, and (3) national survey of orthopaedic surgeons managing hip displacement in children with CP. RESULTS: Fifteen articles were included in the systematic review. Quantitative analysis was not possible...
September 2015: Developmental Medicine and Child Neurology
Seung Yeol Lee, Chin Youb Chung, Kyoung Min Lee, Soon-Sun Kwon, Kyu-Jung Cho, Moon Seok Park
PURPOSE: We estimated the annual changes in radiographic indices of the spine in cerebral palsy (CP) patients and analyzed the factors that influence its progression rate. METHODS: We included CP patients who had undergone whole-spine radiography more than twice and were followed for at least 1 year. The scoliosis Cobb angle, coronal balance, apical vertebral translation, apical rotation, and pelvic obliquity were measured on anteroposterior (AP) radiographs; thoracic kyphosis and lumbar lordosis angles, and sagittal balance was measured on lateral radiographs; and migration percentage was measured on AP hip radiographs to determine hip instability...
March 2016: European Spine Journal
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