Pelvic Fixation May Not Be Needed With Cerebral Palsy Scoliosis

Indications ID'd for excluding the pelvis in children with CP scoliosis treated with growth-friendly implants

Child with cerebral palsy on physiotherapy in a children therapy center. Boy with disability doing exercises with physiotherapists in rehabitation centre.
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MONDAY, April 25, 2022 (HealthDay News) -- Distal spine anchors (DSA) may provide better long-term control of the major curve than distal pelvic anchors (DPA) in children with cerebral palsy (CP) scoliosis, according to a study recently published in Spine Deformity.

Ying Li, M.D., from C.S. Mott Children's Hospital in Ann Arbor, Michigan, and colleagues sought to identify indications to exclude the pelvis in children with CP scoliosis treated with growth-friendly instrumentation. A retrospective analysis included children with CP scoliosis treated with traditional growing rods, magnetically controlled growing rod system, or vertical expandable prosthetic titanium rib and at least two years of follow-up.

The researchers identified 27 patients with DSA and 71 patients with DPA placed at the index surgery. Extension of the instrumentation to the pelvis (DSA-EXT) occurred in 22 percent of DSA patients, most commonly at final fusion. Compared with patients who did not require extension, DSA-EXT patients had a higher pre-index L5 tilt (10 versus 19 degrees). At the most recent follow-up, the DSA-EXT group had a lower major curve versus the DPA group (33 versus 58 degrees). Compared with those not requiring extension, the DSA-EXT group had a higher number of complications per patient (1.1 versus 2.3).

"Pre-index L5 tilt ≤10 degrees and pelvic obliquity <10 degrees may be indications to exclude the pelvis in children with CP scoliosis treated with growth-friendly instrumentation," the authors write.

Several authors disclosed financial ties to the medical technology industry.

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