Pelvic obliquity associated with neuromuscular scoliosis in cerebral palsy : cause and treatment
© 2021. Scoliosis Research Society..
STUDY DESIGN: Literature Review.
OBJECTIVE: Review the etiology, clinical manifestations, diagnosis, and treatment of pelvic obliquity in cerebral palsy patients with neuromuscular scoliosis. Neuromuscular scoliosis (NMS) in cerebral palsy (CP) patients is rapidly progressive and often leads to an imbalance in musculoskeletal mechanics that extends to the pelvis. A horizontal misalignment of the pelvis in the frontal plane known as pelvic obliquity (PO) is a common finding in this population. When untreated, PO can exacerbate the back pain, postural strain, and walking difficulties experienced by these patients. Establishing the manifestation and treatment plan for PO in the setting of NMS can provide valuable insight for diagnosis and management.
METHODS: A comprehensive literature review was performed on the etiology, clinical manifestations, diagnosis, and treatment of pelvic obliquity in the setting of NMS in CP. The advantages and limitations of measurement and treatment options were evaluated.
RESULTS: PO is categorized into suprapelvic, infrapelvic, and intrapelvic causes, each presenting with a unique pattern of pathology. NMS in CP with hip contractures and structural deformities fall into these categories. The Maloney and O'Brien methods of pelvic measurement have demonstrated superior utility and are recommended for clinical diagnosis. The management of PO in NMS patients is focused on the cause of malalignment, with posterior fusion, contracture release, and osteotomy encompassing the mainstay of treatment.
CONCLUSION: PO is commonly found in patients with NMS in cerebral palsy. There is currently no standard method for determining the PO angle. Interventions designed to reduce scoliotic curves and release tissue contractures can level the pelvis and restore proper alignment of the spine and sacrum in the coronal plane in these patients. Further understanding of the causes of PO in NMS, as well as the establishment of a standardized measuring technique and diagnostic parameters will allow for more effective treatment options and improve outcomes in patients with CP.
LEVEL OF EVIDENCE: N/A.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
|---|---|
| Enthalten in: |
Spine deformity - 9(2021), 5 vom: 16. Sept., Seite 1259-1265 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Yen, Winston [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cerebral palsy |
|---|
| Anmerkungen: |
Date Completed 19.11.2021 Date Revised 19.11.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s43390-021-00346-y |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM324161212 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM324161212 | ||
| 003 | DE-627 | ||
| 005 | 20231225185726.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s43390-021-00346-y |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1080.xml |
| 035 | |a (DE-627)NLM324161212 | ||
| 035 | |a (NLM)33861427 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Yen, Winston |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pelvic obliquity associated with neuromuscular scoliosis in cerebral palsy |b cause and treatment |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 19.11.2021 | ||
| 500 | |a Date Revised 19.11.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. Scoliosis Research Society. | ||
| 520 | |a STUDY DESIGN: Literature Review | ||
| 520 | |a OBJECTIVE: Review the etiology, clinical manifestations, diagnosis, and treatment of pelvic obliquity in cerebral palsy patients with neuromuscular scoliosis. Neuromuscular scoliosis (NMS) in cerebral palsy (CP) patients is rapidly progressive and often leads to an imbalance in musculoskeletal mechanics that extends to the pelvis. A horizontal misalignment of the pelvis in the frontal plane known as pelvic obliquity (PO) is a common finding in this population. When untreated, PO can exacerbate the back pain, postural strain, and walking difficulties experienced by these patients. Establishing the manifestation and treatment plan for PO in the setting of NMS can provide valuable insight for diagnosis and management | ||
| 520 | |a METHODS: A comprehensive literature review was performed on the etiology, clinical manifestations, diagnosis, and treatment of pelvic obliquity in the setting of NMS in CP. The advantages and limitations of measurement and treatment options were evaluated | ||
| 520 | |a RESULTS: PO is categorized into suprapelvic, infrapelvic, and intrapelvic causes, each presenting with a unique pattern of pathology. NMS in CP with hip contractures and structural deformities fall into these categories. The Maloney and O'Brien methods of pelvic measurement have demonstrated superior utility and are recommended for clinical diagnosis. The management of PO in NMS patients is focused on the cause of malalignment, with posterior fusion, contracture release, and osteotomy encompassing the mainstay of treatment | ||
| 520 | |a CONCLUSION: PO is commonly found in patients with NMS in cerebral palsy. There is currently no standard method for determining the PO angle. Interventions designed to reduce scoliotic curves and release tissue contractures can level the pelvis and restore proper alignment of the spine and sacrum in the coronal plane in these patients. Further understanding of the causes of PO in NMS, as well as the establishment of a standardized measuring technique and diagnostic parameters will allow for more effective treatment options and improve outcomes in patients with CP | ||
| 520 | |a LEVEL OF EVIDENCE: N/A | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Cerebral palsy | |
| 650 | 4 | |a Neuromuscular scoliosis | |
| 650 | 4 | |a Pelvic obliquity | |
| 650 | 4 | |a Review | |
| 700 | 1 | |a Gartenberg, Ariella |e verfasserin |4 aut | |
| 700 | 1 | |a Cho, Woojin |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Spine deformity |d 2013 |g 9(2021), 5 vom: 16. Sept., Seite 1259-1265 |w (DE-627)NLM25039989X |x 2212-1358 |7 nnns |
| 773 | 1 | 8 | |g volume:9 |g year:2021 |g number:5 |g day:16 |g month:09 |g pages:1259-1265 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s43390-021-00346-y |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 9 |j 2021 |e 5 |b 16 |c 09 |h 1259-1265 | ||