[Treatment of spinal deformities in patients with cerebral palsy]

Fifty-five patients with cerebral palsy and spinal deformities were operated on between 1972-1985. 10 had mental retardation related to other etiology than neo-natal encephalopathy where this was found in the remaining 45 patients. 43 curves were paralytic type; 12 were idiopathic type. A non surgical treatment was prescribed to wait for surgery in 32 young children. It was a really followed all along the growth period in only 11 cases. The surgical treatment was often prepared by an halo traction for some days before surgery. The series of patients was divided into two groups: in group I twelve patients were ambulatory, in group II forty three patients were non ambulatory. In the first group, posterior fusion using either Harrington or Luqué or Cotrel-Dubousset instrumentation was done on 10 patients out of 12. In the second group, 21 patients a combined anterior and posterior fusion was done using Dwyer instrumentation anteriorly and Harrington or Cotrel-Dubousset posteriorly. 21 other patients got only the posterior fusion using Luqué or Cotrel-Dubousset instrumentation. Twenty-four out of the 55 had some kind of complications, mainly in the second group (38 p. cent). One death was observed in the immediate postoperative course. The functional results after a follow-up between 2 and 13 years are very encouraging.