Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;12(5):1403-1410.
doi: 10.1007/s43390-024-00880-5. Epub 2024 Apr 29.

Can postoperative Cobb and pelvic obliquity corrections be predicted using supine traction X-rays in non-ambulatory patients with cerebral palsy fused to L5? A case series study

Ruben Alejandro Morales Ciancio  1 , Jonathan Lucas  2 , Stewart Tucker  3 , Thomas Ember  3 , Mark Harris  3 , Edel Broomfield  3
Affiliations

Can postoperative Cobb and pelvic obliquity corrections be predicted using supine traction X-rays in non-ambulatory patients with cerebral palsy fused to L5? A case series study

Ruben Alejandro Morales Ciancio et al. Spine Deform. 2024 Sep.

Abstract

Purpose: This study aimed to determine whether Cobb and pelvic obliquity corrections can be predicted using supine traction radiographs in patients with cerebral palsy (CP) who underwent posterior spinal fusion (PSF) from T2/3 to L5.

Methods: From January 2010 to January 2020, 167 non-ambulatory patients with CP scoliosis underwent PSF using pedicle screws in two quaternary centers with a minimum of 2 years follow-up (FU). Radiological measurements and chart reviews were performed.

Results: A total of 106 patients aged 15.6 ± 0.4 years were included. All patients had significant correction of the Cobb angle (MC), pelvic obliquity (PO), thoracic kyphosis (TK), and lumbar lordosis (LL) without loss of correction at the last FU (LFU). Curve flexibility was significantly correlated with Cobb correction (δMC) immediately postoperatively (p < 0.0001, r = 0.8950), followed by the amount of correction in pelvic obliquity under traction (δPOT) (p = 0.0252, r = 0.2174). For correction in PO (δPO), the most significant variable was δPOT (p < 0.0001, r = 0.7553), followed by curve flexibility (p = 0.0059, r = 0.26) and the amount of correction in Cobb under traction (p = 0.0252, r = 0.2174).

Conclusions: Cobb and PO corrections can be predicted using supine traction films for non-ambulatory CP patients treated with PSF from T2/3 to L5. The variables evaluated were interconnected, reinforcing preoperative planning for these patients. Comparative large-scale studies on patient-related clinical outcomes are required to determine whether this predicted correction is associated with improved surgical outcomes and reduced complication rates.

Level of evidence: IV.

Keywords: Cerebral palsy; Neuromuscular scoliosis; Non-ambulatory; Pelvic obliquity correction; Scoliosis surgery.

PubMed Disclaimer

References

    1. Hagglund G et al (2018) Incidence of scoliosis in cerebral palsy. Acta Orthop 89(4):443–447 - DOI - PubMed - PMC
    1. Ilharreborde B et al (2020) Spinal sagittal alignment and head control in patients with cerebral palsy. J Child Orthop 14(1):17–23 - DOI - PubMed - PMC
    1. Loughenbury PR, Tsirikos AI (2022) Current concepts in the treatment of neuromuscular scoliosis: clinical assessment, treatment options, and surgical outcomes. Bone Jt Open 3(1):85–92 - DOI - PubMed - PMC
    1. Kim HS, Kwon JW, Park KB (2022) Clinical issues in indication, correction, and outcomes of the surgery for neuromuscular scoliosis narrative review in pedicle screw era. Neurospine 19:177–187 - DOI - PubMed - PMC
    1. Chaudry Z, Anderson JT (2017) Curve flexibility in cerebral palsy-related neuromuscular scoliosis: does the intraoperative prone radiograph reveal more flexibility than preoperative radiographs? Scoliosis Spinal Disord 12:15 - DOI - PubMed - PMC

MeSH terms