Cerebral palsy and spinal deformities

Cerebral palsy is a common static encephalopathy and can present as multiple musculoskeletal problems. Increased peripheral muscle tone causes joint contractures and decreased functional capacity. The risk for scoliosis increases parallel with the severity of musculoskeletal involvement. Scoliosis adversely affects the functional capacity, daily care, and nutrition in disabled children. Conservative treatments including physical therapy, bracing, and botulinum toxin injections do not prevent the progression of scoliosis in most of the patients and surgical treatment becomes mandatory. With the use of pedicle screws, three-plane fixation is possible, making posterior instrumentation and fusion effective in correction of severe curves and obviating anterior surgery.