Some children with cerebral palsy scoliosis may not need pelvic fixation, study shows (Creates more damage than it benefits, for those with less than 10 degree tilt)

Medical Xpress / University of Michigan / Spine Deformity ^ | Apr. 18, 2022 | Ying Li et al

[ConservativeMind]

A new study finds that some children with cerebral palsy and scoliosis do not require pelvic fixation when undergoing growing rod treatment, potentially avoiding several complications.

Researchers analyzed pediatric patients with cerebral palsy and scoliosis treated with growth-friendly implants, in which expandable rods are inserted into the back to help control the spinal curvature while still allowing the spine to grow. They found that for children with a pelvic tilt and lower lumbar spine tilt of fewer than 10 degrees, the pelvis did not need to be included when inserting growing rods.

"Inserting screws into the pelvis to anchor the growing rods is not benign; screws in that area tend to be more prominent," said G. Ying Li, M.D.

"Prominent screws can be painful and can also cause overlying skin breakdown, leading to infection. In the past, there has also been a high rate of these screws failing. Understanding which kids have enough of a tilt in their pelvis and lower lumbar spine to benefit from anchoring the rods into the pelvis is important."

Children with cerebral palsy have abnormal nerve and muscle control, and many of them are wheelchair users. When they develop scoliosis, the curve in their spine tends to be longer and more sweeping than those without the condition. The curve may extend into the pelvis, affecting standing and sitting balance and causing pressure that can make sitting more painful or lead to skin breakdown.

Patients treated with growing rods require more than one surgery, and most children eventually need a spinal fusion. Growth-friendly treatment is already associated with more complications than a single spinal fusion. For patients with cerebral palsy who have a small enough pelvic tilt, Li says, it is beneficial to avoid inserting screws into the pelvis in the early stages of growth-friendly treatment.

[ConservativeMind]

This would provide a better quality of life with apparently no demonstrable negatives, for those with 10 degrees of tilt or less.

[ConservativeMind]

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[oblomov]

I was one of these kids. Fortunately, no adjustments or implants were done. I mostly grew out of the problem.

As an adult, I do have to be careful not to have sacroiliac laxity when doing heavy exercise (e.g. squats). I just focus on maintaining perfect/ideal form, and avoid injury and pain.

[ConservativeMind]

Good for you!

Most people are not aware what you did was even possible.

Thank you for sharing.