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Intrathecal baclofen pumps do not accelerate progression of scoliosis in quadriplegic spastic cerebral palsy.
Eur Spine J. 2017 06; 26(6):1652-1657.ES

Abstract

PURPOSE

To compare scoliosis progression in quadriplegic spastic cerebral palsy with and without intrathecal baclofen (ITB) pumps.

METHODS

A retrospective matched cohort study was conducted. Patients with quadriplegic spastic cerebral palsy, GMFCS level 5, treated with ITB pumps with follow-up >1 year were matched to comparable cases by age and baseline Cobb angle without ITB pumps. Annual and peak coronal curve progression, pelvic obliquity progression and need for spinal fusion were compared.

RESULTS

ITB group: 25 patients (9 female), mean age at pump insertion 9.4 and Risser 0.9. Initial Cobb angle 25.6° and pelvic tilt 3.2°. Follow-up 4.3 (1.0-7.8) years. Cobb angle at follow-up 76.1° and pelvic tilt 18.9°. Non-ITB group: 25 patients (14 female), mean age at baseline 9.2 and Risser 1.0. Initial Cobb angle 29.7° and pelvic tilt 7.1°. Follow-up 3.5 (1.0-7.5) years. Cobb angle at follow-up 69.1° and pelvic tilt 21.0°. The two groups were statistically similar for baseline age, Cobb angle and Risser grade. Mean curve progression was 13.6°/year for the ITB group vs 12.6°/year for the non-ITB group (p = 0.39). Peak curve progression was similar between the groups. Pelvic tilt progression was comparable; ITB group 4.5°/year vs non-ITB 4.6°/year (p = 0.97). During follow-up 5 patients in the ITB group and 9 in the non-ITB group required spinal fusion surgery for curve progression (p = 0.35).

CONCLUSIONS

Patients with quadriplegic spastic cerebral palsy with and without ITB pumps showed significant curve progression over time. ITB pumps do not appear to alter the natural history of curve progression in this population.

Authors+Show Affiliations

Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK. paulrushton@doctors.org.uk.Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK.Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK.Department of Neurosurgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK.Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK.Department of Neurosurgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27154169

Citation

Rushton, Paul R P., et al. "Intrathecal Baclofen Pumps Do Not Accelerate Progression of Scoliosis in Quadriplegic Spastic Cerebral Palsy." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 26, no. 6, 2017, pp. 1652-1657.
Rushton PRP, Nasto LA, Aujla RK, et al. Intrathecal baclofen pumps do not accelerate progression of scoliosis in quadriplegic spastic cerebral palsy. Eur Spine J. 2017;26(6):1652-1657.
Rushton, P. R. P., Nasto, L. A., Aujla, R. K., Ammar, A., Grevitt, M. P., & Vloeberghs, M. H. (2017). Intrathecal baclofen pumps do not accelerate progression of scoliosis in quadriplegic spastic cerebral palsy. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 26(6), 1652-1657. https://doi.org/10.1007/s00586-016-4598-x
Rushton PRP, et al. Intrathecal Baclofen Pumps Do Not Accelerate Progression of Scoliosis in Quadriplegic Spastic Cerebral Palsy. Eur Spine J. 2017;26(6):1652-1657. PubMed PMID: 27154169.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrathecal baclofen pumps do not accelerate progression of scoliosis in quadriplegic spastic cerebral palsy. AU - Rushton,Paul R P, AU - Nasto,Luigi A, AU - Aujla,Ranjit K, AU - Ammar,Amr, AU - Grevitt,Michael P, AU - Vloeberghs,Michael H, Y1 - 2016/05/06/ PY - 2016/01/20/received PY - 2016/04/29/accepted PY - 2016/04/28/revised PY - 2016/5/8/pubmed PY - 2018/2/22/medline PY - 2016/5/8/entrez KW - Cerebral palsy KW - Intrathecal baclofen KW - Scoliosis KW - Spastic quadriplegia SP - 1652 EP - 1657 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 26 IS - 6 N2 - PURPOSE: To compare scoliosis progression in quadriplegic spastic cerebral palsy with and without intrathecal baclofen (ITB) pumps. METHODS: A retrospective matched cohort study was conducted. Patients with quadriplegic spastic cerebral palsy, GMFCS level 5, treated with ITB pumps with follow-up >1 year were matched to comparable cases by age and baseline Cobb angle without ITB pumps. Annual and peak coronal curve progression, pelvic obliquity progression and need for spinal fusion were compared. RESULTS: ITB group: 25 patients (9 female), mean age at pump insertion 9.4 and Risser 0.9. Initial Cobb angle 25.6° and pelvic tilt 3.2°. Follow-up 4.3 (1.0-7.8) years. Cobb angle at follow-up 76.1° and pelvic tilt 18.9°. Non-ITB group: 25 patients (14 female), mean age at baseline 9.2 and Risser 1.0. Initial Cobb angle 29.7° and pelvic tilt 7.1°. Follow-up 3.5 (1.0-7.5) years. Cobb angle at follow-up 69.1° and pelvic tilt 21.0°. The two groups were statistically similar for baseline age, Cobb angle and Risser grade. Mean curve progression was 13.6°/year for the ITB group vs 12.6°/year for the non-ITB group (p = 0.39). Peak curve progression was similar between the groups. Pelvic tilt progression was comparable; ITB group 4.5°/year vs non-ITB 4.6°/year (p = 0.97). During follow-up 5 patients in the ITB group and 9 in the non-ITB group required spinal fusion surgery for curve progression (p = 0.35). CONCLUSIONS: Patients with quadriplegic spastic cerebral palsy with and without ITB pumps showed significant curve progression over time. ITB pumps do not appear to alter the natural history of curve progression in this population. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/27154169/Intrathecal_baclofen_pumps_do_not_accelerate_progression_of_scoliosis_in_quadriplegic_spastic_cerebral_palsy_ L2 - https://doi.org/10.1007/s00586-016-4598-x DB - PRIME DP - Unbound Medicine ER -