Impact of orthoses on the rate of scoliosis progression in children with cerebral palsy

Abstract

This study was undertaken to determine the impact of spinal bracing on curve pattern and the rate of progression of neuromuscular scoliosis in children with cerebral palsy. Twenty-one patients were treated with a Wilmington custom-molded orthosis with 23 h a day brace wear for a mean bracing period of 67 months (range, 22-173). Twenty-two patients had a similar follow-up to spinal fusion but had no bracewear. Patients who were braced had a scoliosis that reached a magnitude of 50 degrees at a mean 12.5 years, compared with a mean age of 14 years for those who were not braced (p > 0.05). Spinal orthotics had no impact on scoliosis curve, shape, or rate of progression in spastic quadriplegic patients who were followed-up on fusion. Apical vertebral rotation > 2 (Nash and Moe criteria) is an indicator of impending rapid progression of the scoliosis curve.