Concept and treatment outcomes of dynamic spinal brace for scoliosis in cerebral palsy

Kajiura, Ichiro; Kawabata, Hidehiko; Okawa, Atsuko; Yukiyasu, Minobe; Matsuyama, Motoaki; Yoshida, Kiyoshi; Suzuki, Tsuyoshi

doi:10.1097/bpb.0000000000000580

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…Kajiura et al. 13 ) developed the DSB, a novel device with the basic concept of automatic correction by maximizing posture control. Nakamura et al 14 ) reported that DSB treatment may be effective when worn during the early stage of scoliosis.…”

Section: Discussionmentioning

confidence: 99%

Progressive age and other factors affecting scoliosis severity in cerebral palsy patients

et al. 2020

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Objective: This study aimed to investigate the age at which scoliosis progresses to a severe condition and identify the factors related to severe scoliosis in patients with cerebral palsy. Patients and Methods: This retrospective study included 51 patients aged ≥15 years. The Cobb angle was measured over time using radiographs. Patients were divided into the following groups according to their final Cobb angle: <60°, 60°-100°, and ≥100°. The age at which the Cobb angle was ≥20° in the patients was compared among the groups. Moreover, the age at which a significant difference in the Cobb angle occurred in the groups was considered the age at which the scoliosis worsened. Association of the final Cobb angle with factors such as the location of curve, Gross Motor Functional Classification System (GMFCS), capability of turning over, orthosis use, hip dislocation, tracheotomy, and gastric fistula was examined. Results: The mean age at which the Cobb angle was ≥20° was significantly lower in the ≥100° group. From 9 years of age, a significant difference was noted in the Cobb angle between the <60° group and ≥100° group. Between 13-19 years, a significant difference in the Cobb angle was observed among the three groups. Furthermore, GMFCS, capability of turning over, hip dislocation, and gastric fistula were the factors showing a significant difference among the three groups. Conclusion: Scoliosis progressed to the severe form (Cobb angle ≥100°) at 9 years of age. Moreover, scoliosis is aggravated during the growth period. Severe cerebral palsy with low motor function levels and problems with internal functions was considered the cause of scoliosis deterioration.

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Section: Discussionmentioning

confidence: 99%

Progressive age and other factors affecting scoliosis severity in cerebral palsy patients

et al. 2020

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“…4 Brace treatment at an early stage is an option to improve stability, trunk positioning, head control and upper extremity function but most likely may not alter the natural history of progressive deformity, not even after the end of growth. 5,6 Curve size and stiffness, chest wall deformities, rib and skin fragility are limiting factors for trunk orthoses.…”

Section: Introductionmentioning

confidence: 99%

Spine deformities in patients with cerebral palsy; the role of the pelvis

Hasler

Brunner

Grundshtein

et al. 2020

Journal of Children's Orthopaedics

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Introduction Progressive neuromuscular spinal deformities with pelvic obliquity and loss of sitting balance are typical features of severely affected patients with cerebral palsy. The pelvis represents the key bone between the spine and the lower extremity when it comes to deciding whether and when to operate and if spine or hip surgery first is beneficial. The pelvis can be looked at as the lowest vertebra and as the rooftop of the lower extremities. Biomechanical considerations To allow for a normal spinal shape, the pelvis needs to be horizontal in the frontal plane and mildly anterior tilted in the sagittal plane, less for sitting and more for standing. Any abnormal pelvic position requires spinal compensation and challenges the equilibrium control of the individual. Both anatomical neighbourhoods – the spine and the hip joints — have to be considered when spinal deformities, hip instability and contractures evolve, in conservative therapy (bracing, physiotherapy, seating in the wheelchair) and when surgical interventions are weighed out against each other. Surgical considerations Multiple anatomical factors such as sagittal profile and pelvic orientiation, pelvic transverse plane asymmetries and lumbosacral malformations have to be considered in case the pelvis is instrumented with sacral and iliac screws. Rotational deformities and asymmetries of the pelvic bones make the safe insertion of long screws challenging. Advantages of primary pelvic fixation include correction of pelvic obliquity, especially considering the lever arm of the whole spinal construct. The risk of revision surgery due to progression of distal curves is also reduced. Disadvantages of pelvic fixation include the complexity of the additional intervention, which may result in longer operating times, increased risk of blood loss, infection and hardware malpositioning.

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Effectiveness of postural interventions in cerebral palsy: umbrella systematic review

Toohey,

Blatch-Williams,

Budini

et al. 2024

Paediatrics and Child Health

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Concept and treatment outcomes of dynamic spinal brace for scoliosis in cerebral palsy

Cited by 3 publications

References 16 publications

Progressive age and other factors affecting scoliosis severity in cerebral palsy patients

Progressive age and other factors affecting scoliosis severity in cerebral palsy patients

Spine deformities in patients with cerebral palsy; the role of the pelvis

Effectiveness of postural interventions in cerebral palsy: umbrella systematic review

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