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Cerebral Palsy - Spinal Disorders
Posted: Oct 17 2018 #(C101114)
A

Scoliosis in 6F with Cerebral Palsy

HPI

Severe CP and Developmental Delay Trach

PMH

Developmental Delay, Tracheostomy

PE

Extremely thin. Poor soft tissue coverage over convex ribs and spine

Poll
1 of 9
1. Would you use a classification system to guide treatment?
Yes - Weinstein Classification
31%
120/377
Yes - EOS Classification
23%
90/377
No - I would not use a Classification System to Guide Treatment
23%
90/377
Outside my area of expertise
20%
77/377
2. Would you obtain an MRI PreOp?
No
13%
48/354
Yes
81%
287/354
Outside my area of expertise
5%
19/354
3. How would you treat this patient at this time
Observation now and Early Fusion at 10 years of age
14%
51/352
Bracing/Casting & Custom Seat
28%
100/352
Operative Treatment Now
49%
173/352
Outside my area of expertise
7%
28/352
4. If choosing Operative Treatment now, what procedure would you perform?
Posterior Spine Fusion
10%
34/337
Anterior & Posterior Spine Fusion
8%
28/337
Growing Rods
65%
221/337
Posterior Tether
2%
9/337
I would not perform operative treatment now
6%
23/337
Outside my area of expertise
6%
22/337
5. If placing growing rods what levels would you include
T2 to L5
16%
54/326
T4 to L5
10%
34/326
T2 to pelvis
52%
171/326
T4 to pelvis
9%
31/326
I would not place growing rods
2%
8/326
Outside my area of expertise
8%
28/326
6. If using growing rods what type of pelvis anchors would you use?
Iliac Bolts
16%
49/300
S hooks
13%
39/300
SAI (Sacral-alar-iliac) screws
41%
124/300
Pelvic Saddles
8%
25/300
I would not go to the pelvis
4%
13/300
I would not place growing rods
2%
6/300
Outside my area of expertise
14%
44/300
7. What type of rods would you use?
Traditional growing rods
14%
41/288
Single magnetic growing rod
12%
37/288
Double magnetic growing rods in standard-offset configuration
35%
102/288
Double magnetic growing rods in standard-standard configuration
19%
55/288
I would not place growing rods
2%
7/288
Outside my area of expertise
15%
46/288
8. What type of upper anchors would you use?
Rib hooks
14%
41/282
Pedicle screws
41%
117/282
Spine hooks
19%
55/282
Claw/VEPTR
10%
31/282
I would not place growing rods
1%
5/282
Outside my area of expertise
11%
33/282
9. If using magnetically lengthening rods how often would you lengthen?
once a month
16%
48/294
Every 6 weeks
13%
40/294
Every 3 months
32%
95/294
Every 6 months
25%
74/294
I would not place growing rods
1%
5/294
Outside my area of expertise
10%
32/294
PROCEDURE #1 DOP: 1/3/2018

Magnetic Growing Rod Placement

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OUTCOMES
1 day after
Post-procedure P1
8 months after
Post-procedure P1
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