Madigan R R, Wallace S L
Spine (Phila Pa 1976). 1981 Nov-Dec;6(6):583-90. doi: 10.1097/00007632-198111000-00009.
A prospective review of 272 institutionalized cerebral palsy residents was undertaken in order to determine the incidence and characteristics of neuromuscular scoliosis in this population. The types of cerebral palsy in the group consisted of 75% spastic, 8% dyskinetic, 4% ataxic, 8% mixed, and 5% undefined. There was a 64% incidence of roentgenographic scoliosis greater than 10 degrees. Two distinct curve patterns were determined with equal frequency, single and multiple. The significance of the curve patterns could not be determined. Scoliosis was most common in the spastic group with the highest incidence in the spastic quadriplegics. The incidence directly paralleled the severity of the neurologic deficit but also appeared to be aggravated by the effects of gravity when the individuals were artificially placed in the sitting position. There was a definite inverse relationship between the level of ambulation and scoliosis: the higher the level of ambulation the lower the incidence of scoliosis. Hip stability per se could not be correlated with the incidence of scoliosis. The most important factors in predicting scoliosis in this population are the presence of spasticity and the severity of the neurologic deficit.
对272名机构收容的脑瘫患者进行了前瞻性研究，以确定该人群中神经肌肉型脊柱侧弯的发病率和特征。该组脑瘫类型包括75%痉挛型、8%运动障碍型、4%共济失调型、8%混合型和5%未明确型。X线显示脊柱侧弯大于10度的发病率为64%。确定了两种不同的曲线模式，单一型和复合型，出现频率相同。曲线模式的意义无法确定。脊柱侧弯在痉挛型组中最为常见，在痉挛性四肢瘫患者中发病率最高。发病率与神经功能缺损的严重程度直接相关，但当患者被人为置于坐位时，重力作用似乎也会加重病情。行走能力水平与脊柱侧弯之间存在明确的反比关系：行走能力水平越高，脊柱侧弯的发病率越低。髋关节稳定性本身与脊柱侧弯的发病率无关。预测该人群脊柱侧弯的最重要因素是痉挛的存在和神经功能缺损的严重程度。
