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Scoliosis usually started before the age of 10 years and progressed rapidly during the growth period.In many cases,even after growth had ended,continuous progression was seen.The mean magnitude of the curves at final examination was 55 degrees(Cobb angle).In 11(85%)of 13 patients who had a spinal curve of more than 40 degrees before age 15 years,the scoliosis progressed to more than 60 degrees by the time of final examination.Meanwhile,in only three(13%)of 24 patients who had a curve of less than 40 degrees at age 15,did the scoliosis progress to more than 60 degrees.Severe scoliosis developed predominantly in those who had total body involvement(67%),were bedridden(100%),or had thoracolumbar curves (57%).The risk factors for progression of scoliosis in spastic cerebral palsy are:having a spinal curve of 40 degrees before age 15 years,having total body involvement,being bedridden,and having a thoracolumbar curve. Patients with these risk factors might benefit from early surgical intervention to prevent progression to severe scoliosis. |
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