Natural History of Scoliosis in Nonambulatory Spastic Tetraplegic Cerebral Palsy

Objective To analyze the development and progression of scoliosis in children and adolescents with nonambulatory spastic tetraplegic cerebral palsy. Design Retrospective longitudinal review. Setting Pediatric nursing home. Participants A total of 110 children and adolescents 40° by age 12 years, scoliosis was more likely to progress than if the Cobb angle was ≤40°. The effect of age was stronger for those with history of tracheostomy (age slope = 0.631 vs 0.281) than those without. The relationship of age and Cobb angle did not differ significantly between hip dislocated and non–hip-dislocated groups. Conclusions Age was found to be the most significant predictor of Cobb angle, and the effect of age was greater in the tracheostomy group than in the nontracheostomy group. After adjustment for age, the weight and height were not significant predictors of Cobb angle. Cobb angles of >40° by the age of 12 years were associated with greater increases in Cobb angle with age.