Bertoncelli Carlo M, Solla Federico, Loughenbury Peter R, Tsirikos Athanasios I, Bertoncelli Domenico, Rampal Virginie
1 Department of Paediatric Orthopaedic Surgery, Lenval University Paediatric Hospital of Nice, Nice, France.
2 Scottish National Spine Deformity Centre, Royal Hospital for Sick Children, University of Edinburgh, Edinburgh, United Kingdom.
J Child Neurol. 2017 Jun;32(7):657-662. doi: 10.1177/0883073817701047. Epub 2017 Apr 10.
This study aims to identify the risk factors leading to the development of severe scoliosis among children with cerebral palsy. A cross-sectional descriptive study of 70 children (aged 12-18 years) with severe spastic and/or dystonic cerebral palsy treated in a single specialist unit is described. Statistical analysis included Fisher exact test and logistic regression analysis to identify risk factors. Severe scoliosis is more likely to occur in patients with intractable epilepsy ( P = .008), poor gross motor functional assessment scores ( P = .018), limb spasticity ( P = .045), a history of previous hip surgery ( P = .048), and nonambulatory patients ( P = .013). Logistic regression model confirms the major risk factors are previous hip surgery ( P = .001), moderate to severe epilepsy ( P = .007), and female gender ( P = .03). History of previous hip surgery, intractable epilepsy, and female gender are predictors of developing severe scoliosis in children with cerebral palsy. This knowledge should aid in the early diagnosis of scoliosis and timely referral to specialist services.
本研究旨在确定导致脑瘫患儿发生严重脊柱侧弯的风险因素。本文描述了一项对在单一专科单位接受治疗的70名（年龄在12至18岁之间）患有严重痉挛型和/或张力障碍型脑瘫儿童的横断面描述性研究。统计分析包括Fisher精确检验和逻辑回归分析以确定风险因素。严重脊柱侧弯更有可能发生在患有难治性癫痫（P = 0.008）、粗大运动功能评估得分低（P = 0.018）、肢体痉挛（P = 0.045）、既往有髋关节手术史（P = 0.048）以及非步行患者（P = 0.013）中。逻辑回归模型证实主要风险因素为既往髋关节手术（P = 0.001）、中度至重度癫痫（P = 0.007）以及女性性别（P = 0.03）。既往髋关节手术史、难治性癫痫和女性性别是脑瘫患儿发生严重脊柱侧弯的预测因素。这些知识应有助于脊柱侧弯的早期诊断并及时转诊至专科服务机构。
