Department of Paediatrics-Developmental Neurology, University Medical Center Groningen, Hanzeplein 1, Groningen, the Netherlands.
Dev Med Child Neurol. 2010 Jul;52(7):605-11. doi: 10.1111/j.1469-8749.2010.03617.x. Epub 2010 Mar 19.
Scoliosis is a frequently occurring and serious complication of severe cerebral palsy (CP). This systematic review aims to the assess the risk factors associated with the emergence and progression of scoliosis in children with CP functioning at level IV or V of the Gross Motor Function Classification System (GMFCS).
Relevant studies conducted from 1966 to March 2009 were identified in Embase, Medline, and Scopus. The methodological quality of the studies was assessed and relations between risk factors and scoliosis were documented systematically.
Ten studies were included. They had a low level of evidence and heterogeneous methodological quality. No systematic associations were found between type of CP and scoliosis or between age, type, and location of scoliotic curve and progression of scoliosis. Weak evidence was present for an association between the severity of CP, hip dislocation, and pelvic obliquity and scoliosis.
The low level of evidence precludes the drawing of firm conclusions on risk factors for the emergence and progression of scoliosis in children with severe CP. However, given the high prevalence of the disorder and its serious consequences for daily life, more research in this area is urgently needed.
脊柱侧弯是严重脑瘫（CP）的一种常见且严重的并发症。本系统评价旨在评估与 CP 患儿在粗大运动功能分级系统（GMFCS）IV 或 V 级功能水平时发生和进展的脊柱侧弯相关的风险因素。
从 1966 年至 2009 年 3 月，在 Embase、Medline 和 Scopus 中确定了相关研究。系统地评估了研究的方法学质量，并记录了风险因素与脊柱侧弯之间的关系。
纳入了 10 项研究。这些研究的证据水平较低，方法学质量存在异质性。CP 的类型与脊柱侧弯之间，以及脊柱侧弯的类型、部位与进展之间均无系统相关性。CP 的严重程度、髋关节脱位和骨盆倾斜与脊柱侧弯之间存在弱相关性证据。
由于证据水平较低，因此无法就严重 CP 患儿脊柱侧弯发生和进展的风险因素得出确切结论。然而，鉴于该疾病的高患病率及其对日常生活的严重后果，迫切需要在该领域开展更多研究。
