Spine and Scoliosis in Cerebral Palsy Wheeless

Description: Wheeless' Textbook of Orthopaedics
Non Operative Treatment: - many patients can achieve functional sitting with body jackets or molded wheelchair inserts; - custom molded seat insertes allow better positioning but do not prevent curve progression; - Surgical Treatment: - w/ spastic quadriplegia scoliosis can be especially severe, and is associated with an increased incidence of pseudoarthrosis if treated with conventional posterior fusion; - anterior and posterior fusion or segmental instrumentation is favored in patients who can no longer sit properly; - curves> 80 deg, rigid curves, and those w/ severe pelvic obliquity require combined anterior & posterior arthrodesis; - fusion to the sacrum is required with a fixed pelvic obliquity (eg. with Luque rods to the pelvis - Galveston technique); - kyphosis is also common and may require fusion & instrumentation;