Association of Severity of Scoliosis with Neurological and Functional Deficits in Cerebral Palsy

臺灣腦性麻痺與脊柱側彎嚴重度相關性研究

于瑛輝(Young-Hue Yu) ； 李建輝(Chien-Hui Lee) ； 呂逸群(I-Chiun Lu) ； 林見榮(Chien-Jung Lin) ； 莊國瑋(Kuo-Wei Chuang) ； 陳克銘(Ke-Ming Chen)

《北市醫學雜誌》 5卷2期 (2008/04) Pp. 223-230

https://doi.org/10.6200/TCMJ.2008.5.2.06

摘要

Background and Purpose: To analyze the prevalence and severity of scoliosis in institutionalized patients with cerebral palsy (CP) and to specifically evaluate the correlation between the severity of scoliosis and neurological or functional deficits. Methods: A board-certified physiatrist examined and interpretated spine plain film all 328 residents, age was 10-52 years of an institution located in Taipei, Taiwan. The prevalence of scoliosis, the severity of scoliosis (as reflected by Cobb method), and the correlation among the degree of spasticity (as reflected by Modified Ashworth Scale), the curvature of scoliosis and the functional impairment, were analysed. Results: Sixty-six residents had CP and the spastic type (48/66) was the most common. The prevalence of the scoliosis with CP patients in this institution was 62% (41/66), also as high as 73% scoliosis in spastic quadriplegia. In terms of three types of functional status: bedridden were 17/22 (77%) with scoliosis; sitters were 14/23 (61%) with scoliosis and ambulators were 10/21 (48%) with scoliosis; their mean Cobb angle were 46.1º±18.4º, 27.8º±7.4º and 16.1º±3.9º, respectively (P＜0.05). The spasticity with Modified Ashworth Scale were 3.7±0.7 in severe scoliosis (Cobb angle＞40º), 2.9±0.9 in moderate scoliosis (Cobb angle 20º-40º), and 2.0±1.2 in mild scoliosis (Cobb angle＜20º) (P＜0.01), also significantly correlated with functional deficits. Conclusion: The prevalence and the severity of scoliosis in patients with CP were correlated with neurological impairment, degree of spasticity, and functional disability. Early detection, early management and long-term follow up are necessary.

關鍵字

脊椎側彎 ； 腦性麻痺 ； 痙攣 ； 功能性損傷

並列摘要

Background and Purpose: To analyze the prevalence and severity of scoliosis in institutionalized patients with cerebral palsy (CP) and to specifically evaluate the correlation between the severity of scoliosis and neurological or functional deficits. Methods: A board-certified physiatrist examined and interpretated spine plain film all 328 residents, age was 10-52 years of an institution located in Taipei, Taiwan. The prevalence of scoliosis, the severity of scoliosis (as reflected by Cobb method), and the correlation among the degree of spasticity (as reflected by Modified Ashworth Scale), the curvature of scoliosis and the functional impairment, were analysed. Results: Sixty-six residents had CP and the spastic type (48/66) was the most common. The prevalence of the scoliosis with CP patients in this institution was 62% (41/66), also as high as 73% scoliosis in spastic quadriplegia. In terms of three types of functional status: bedridden were 17/22 (77%) with scoliosis; sitters were 14/23 (61%) with scoliosis and ambulators were 10/21 (48%) with scoliosis; their mean Cobb angle were 46.1º±18.4º, 27.8º±7.4º and 16.1º±3.9º, respectively (P＜0.05). The spasticity with Modified Ashworth Scale were 3.7±0.7 in severe scoliosis (Cobb angle＞40º), 2.9±0.9 in moderate scoliosis (Cobb angle 20º-40º), and 2.0±1.2 in mild scoliosis (Cobb angle＜20º) (P＜0.01), also significantly correlated with functional deficits. Conclusion: The prevalence and the severity of scoliosis in patients with CP were correlated with neurological impairment, degree of spasticity, and functional disability. Early detection, early management and long-term follow up are necessary.

並列關鍵字

Scoliosis ； Cerebral palsy ； Spasticity ； Functional deficits