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Risk factors for emergence and progression of scoliosis in children
with severe cerebral palsy: a systematic review
MARIANNE J B LOETERS 1,2 | CAREL G B MAATHUIS1,3 | MIJNA HADDERS-ALGRA1
1 Department of Paediatrics – Developmental Neurology, University Medical Center Groningen, Groningen, the Netherlands. 2 Community Clinic for Paediatric Physical Therapy, Vries and Assen, the Netherlands. 3 Center for Rehabilitation, University Medical Center Groningen, Groningen, the Netherlands. Correspondence to Dr Mijna Hadders-Algra, University Medical Center Groningen, Developmental Neurology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands. E-mail: m.hadders-algra@med.umcg.nl
PUBLICATION DATA Accepted for publication 10th December 2009. Published online 19th March 2010.
LIST OF ABBREVIATION TMQS Total Methodological Quality Score
AIM
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 GrossMotor Function Classification System(GMFCS).
METHOD
Relevant studies conducted from1966 to March 2009 were identified in Embase, Medline,and Scopus. The methodological quality of the studies was assessed and relations betweenrisk factors and scoliosis were documented systematically.
RESULTS
Ten studies were included. They had a low level of evidence and heterogeneous methodologicalquality. No systematic associations were found between type of CP and scoliosis orbetween 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.
INTERPRETATION
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.DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY REVIEW
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