Neuromuscular Scoliosis
A 14-year-old non-ambulatory boy with spastic quadriplegic cerebral palsy (GMFCS Level V) presents with progressive spinal deformity. He is gastrostomy-fed due to dysphagia. Sitting balance has deteriorated, requiring increased trunk support, and caregivers report difficulty with positioning and hygiene. Spinal radiographs show a 75-degree thoracolumbar curve with 25-degree pelvic obliquity. He has had recurrent chest infections and has a baseline FVC of 35% predicted. Regarding the management of neuromuscular scoliosis in cerebral palsy:
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Neuromuscular scoliosis differs from idiopathic scoliosis by typically involving long C-shaped curve...
Surgical fusion in GMFCS V cerebral palsy typically requires posterior instrumentation from upper th...
Low FVC (35% predicted) is an absolute contraindication to surgery; posterior-only fusion is insuffi...
Perioperative complications are significantly higher than idiopathic scoliosis including respiratory...
Outcomes in GMFCS Level V patients show improved sitting balance, caregiver satisfaction, and qualit...
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