Interspinous process segmental spinal instrumentation for scoliosis in cerebral palsy

Interspinous process segmental instrumentation (ISSI) was used in 34 patients with scoliosis due to severe cerebral palsy. Average age was 17 years, and average curve was 82 degrees. Anterior fusion was performed in 21 patients before ISSI. Mean correction was 50.5%, and progression averaged 5 degrees at the 22-month follow-up. Posterior fusion alone gave good results in smaller curves. A brace was needed only for severe movement disorders. Gross functional level improved in fewer than one-third of patients. Minor gains were made by 74%. ISSI is effective in severe cerebral palsy. It may be used alone in the smaller (less than 80 degrees), more supple curves.