ICNC Abstracts, ICNC 2018

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Frequency and predictive factors of scoliosis in Malaysian children with Cerebral Palsy

Last modified: 2018-09-09


Objective: Scoliosis is a common musculoskeletal condition seen in children with cerebral palsy (CP). To describe the prevalence of scoliosis and to analyze the relation between scoliosis, gross motor function, and CP subtypes in order to propose a surveillance programme for children with CP in Malaysia.

Methods: Cross-sectional study of children with CP between 5 to 18 years old were recruited between July 2017 to March 2018. A clinical examination and scoliometer measurement were done and Cobb’s angle were measured on all spine radiographs. The CP subtypes was determined and gross motor function was classified according to the Gross Motor Function Classification System (GMFCS).

Results: Eighty-one children were recruited. 46/81 (56.8%) had scoliosis with Cobb’s angle >200 and 9/81 (11.1%) had severe scoliosis with Cobb’s angle >400. 23/81 (28.4%) were screened between 60-90 months while 35/81 (43.2%) had the first spine radiograph taken after 120 months. Risk of scoliosis was directly related to the GMFCS level, with 30/81 (37.1%) at GMFCS I-III and 51/81 (62.9%) in GMFCS IV-V, r (79) =.61, p < 0.001. Spastic CP 24/46 (52.1%) and mixed spastic and dystonic CP 14/45 (31.1%) had scoliosis. There was a significant positive relationship between scoliometer and Cobb’s angle, r (79) = 0.74, p< 0.001. Those with spine radiographs demonstrated a single curve pattern (95.6%, n=44), commonly to the left side (66.7%, n=30) with the thoracolumbar level most commonly affected (42.2%, n=19).

Conclusion: In this cohort, more than half had scoliosis, with GMFCS level and spastic cerebral palsy as significant predictive factors. Therefore, a spine surveillance programme for children with cerebral palsy in Malaysia is recommended.



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