Scoliosis is an abnormal curvature of the spine from side-to-side. Some people develop the condition because of trauma or other causes, some have it genetically, and some, like people with cerebral palsy, are more predisposed to developing it. It is a painful condition and can cause difficult with sitting and walking. Because of the child’s abnormal posture, pressure sores (also called bedsores and pressure ulcers) can quickly develop. Some children may have difficulty with breathing.
20% of children with cerebral palsy develop scoliosis. It is most common among children with spastic quadriplegia. Scoliosis develops because the abnormal muscle tone in a child with cerebral palsy causes the spine to be pulled in numerous directions. It is more common for bedridden children, or those who cannot sit independently. Beginning around age eight, the spine curves approximately one or two degrees per month.
Treating Scoliosis In Children With Cerebral Palsy
Before treating scoliosis, orthopedists will need to take several x-rays of the spine. It is critical that the same presentation of x-rays be used throughout the child’s life for easy comparison. This can be difficult because children with cerebral palsy often don’t understand the need for these tests, and can be uncooperative. MRIs may be useful if the changes in the spine are more significant than typical.
Doctors may treat scoliosis in a number of ways:
- Braces: TLSO braces (also called Boston Braces) are hard, plastic braces which fit around the torso, and can help a child’s ability to balance while sitting, and may help to slow the progress of scoliosis.
- Custom Seat Orthosis: though this won’t help the course of scoliosis, custom seats can help with comfort and posture.
- Botox Injections: Botox can be injected into muscles of a child with cerebral palsy to help reduce spasticity. The injection can reduce the tension in those muscles, and may help to limit the stress on the spine.
- Surgery: spinal fusion can help in extreme cases. Rods are implanted along the spine to help support proper curvature. Surgery is generally a last resort, particularly because some studies report a 66% rate of major complications.
The goal for any scoliosis treatment is to limit pain, or to preserve or create more freedom of movement. Parents must be prepared to work closely with their doctors and therapists to help enhance their child’s abilities.
Cerebral palsy carries with it a number of complications, including scoliosis for some children. This condition may require extensive and expensive medical management to treat, including potentially surgery. If your child has cerebral palsy and you want to know whether it was preventable, contact our cerebral palsy lawyers at (440) 252-4399, or send us a message through our website.