Curvature of the spine in children with cerebral palsy

Spinal deformities concern 25% of patients with cerebral palsy. Thoracolumbar scoliosis represents the most common pattern of deformity. The balance capacities and postural control are poor in cerebral palsy patients. Spinal curvature creates additional problems for child's posture and locomotion. This can result in loss of functional capacities such as walking, standing or sitting. Pelvic obliquity is an important pathogenic factor. Brace treatment may be effective in small and flexible curves. Indications for surgery should balance the advantages and potential risks of operation. The typical procedure consists of stable segmental instrumentation from posterior approach. The pelvis is usually included in non-ambulatory patient or a case of important pelvic obliquity. The anterior approach may be necessary to improve the flexibility of the curve. Rapid verticalisation, stable fixation sparing the brace immobilization, special nutrition program and respiratory exercises are used in postoperative period.