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. 2018 Aug;89(4):443-447.
doi: 10.1080/17453674.2018.1450091. Epub 2018 Mar 14.

Incidence of scoliosis in cerebral palsy

Gunnar Hägglund  1   2 , Katina Pettersson  1   3 , Tomasz Czuba  4 , Måns Persson-Bunke  1   2 , Elisabet Rodby-Bousquet  1   3
Affiliations

Incidence of scoliosis in cerebral palsy

Gunnar Hägglund et al. Acta Orthop. 2018 Aug.

Abstract

Background and purpose - Surveillance of scoliosis in individuals with cerebral palsy (CP) is important for ensuring timely diagnosis and identification of curve progression. We analyzed the incidence of scoliosis in relation to age, sex, and gross motor function in a population-based cohort of individuals with CP. Patients and methods - This was a prospective register study of all 1,025 individuals born 1990-2012 in southern Sweden (1.4 million inhabitants) in the Swedish surveillance program for CP, which included >95% of the total population of people with CP in the area. Annual clinical examinations and radiographic measurement of the Cobb angle of those with a moderate or severe scoliosis were registered. We determined the incidence of scoliosis related to age, sex, and the Gross Motor Function Classification System (GMFCS) level. Results - The inclusion criteria were fulfilled by 962 individuals. The number of people (140/962) with scoliosis increased up to 20-25 years of age. The incidence of scoliosis was related to age and GMFCS level. In individuals at the lowest level of gross motor function (GMFCS V) scoliosis was seen in 10/131 before 5 years of age and at the age of 20 years 75% of these individuals had a Cobb angle ≥40°. No one in the highest level of motor function (GMFCS I) developed a Cobb angle ≥40° Interpretation - Surveillance programs for scoliosis in CP should be based on age and GMFCS level and should be initiated at a young age and continued into adulthood.

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Figures

Figure 1.
Figure 1.
Percentage of individuals at GMFCS I–V with moderate or severe scoliosis at clinical examination and with a Cobb angle exceeding 20° or 40° at radiographic examination. Individuals with Cobb ≥40° are also included in the presentation of Cobb ≥20°.
Figure 2.
Figure 2.
Survival function with 95% confidence interval showing the risk of having a moderate or severe scoliosis diagnosed at different GMFCS levels and ages. Numbers at risk at inclusion and at 5-year intervals reported.
Figure 3.
Figure 3.
Survival function with 95% confidence interval showing the risk of having a scoliosis with Cobb angle ≥40° diagnosed at different GMFCS levels and ages. Numbers at risk at inclusion and at 5-year intervals reported. For GMFCS color codes see Figure 2.
Figure 4.
Figure 4.
Survival function with 95% confidence interval showing the risk of having a moderate or severe scoliosis in males and females respectively. Numbers at risk at inclusion and at 5-year intervals reported.
See this image and copyright information in PMC

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