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Annual changes in radiographic indices of the spine in cerebral palsy patients

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An Erratum to this article was published on 15 March 2016

Abstract

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. For each gross motor function classification system (GMFCS) level, the Cobb angles, apical vertebral translation, coronal and sagittal balance, and pelvic obliquity were adjusted by multiple factors with a linear mixed model.

Results

A total of 184 patients (774 radiographs) were included in this study. There was no significant annual change in scoliosis Cobb, thoracic kyphosis, and lumbar lordosis angles in the GMFCS level I–II and III groups. In the GMFCS level IV–V group, there was an annual increase of 3.4° in the scoliosis Cobb angle (p = 0.020). The thoracic kyphosis angle increased by 2.2° (p = 0.018) annually in the GMFCS level IV–V group. Apical vertebral translation increased by 5.4 mm (p = 0.029) annually in the GMFCS level IV–V group. Progression of coronal and sagittal balance and pelvic obliquity with aging were not statistically significant. Sex, hip instability, hip surgery, and triradiate cartilage did not affect the progression of scoliosis and the balance of the spine and pelvis.

Conclusions

The scoliosis Cobb angle, thoracic kyphosis angle, and apical vertebral translation in the GMFCS level IV–V CP patients progressed with age. These findings can predict radiographic progression of scoliosis in CP patients.

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Acknowledgments

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. This retrospective study was approved by the institutional review board of our hospital.

Informed consent was waived because of the retrospective nature of the study.

Conflict of interest

None.

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Author notes

    Authors and Affiliations

    1. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-Dong, Bundang-Gu, Sungnam, Kyungki, 463-707, Korea

      Chin Youb Chung, Kyoung Min Lee & Moon Seok Park

    2. Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea

      Seung Yeol Lee

    3. Biomedical Research Institute, Seoul National University Bundang Hospital, Kyungki, Korea

      Soon-Sun Kwon

    4. Department of Orthopaedic Surgery, School of Medicine, Inha University, 7-206, 3 Ga, Sinheung-Dong, Jung-Gu, Incheon, 400-711, Korea

      Seung Yeol Lee & Kyu-Jung Cho

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    1. Seung Yeol Lee
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    2. Chin Youb Chung
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    Correspondence to Kyu-Jung Cho or Moon Seok Park.

    Additional information

    S. Y. Lee and C. Y. Chung contributed equally to the writing of this article.

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    Lee, S.Y., Chung, C.Y., Lee, K.M. et al. Annual changes in radiographic indices of the spine in cerebral palsy patients. Eur Spine J 25, 679–686 (2016). https://doi.org/10.1007/s00586-014-3746-4

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    • DOI: https://doi.org/10.1007/s00586-014-3746-4

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