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Study finds most young patients with cerebral palsy have asymmetric pelvic bones

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Most children with severe cerebral palsy have “starkly asymmetric” pelvic bones, according to research recently published in the Journal of Pediatric Orthopaedics.

“Surgeons preparing to operate on children with cerebral palsy should look out for pelvic asymmetry and tweak their surgical technique accordingly to achieve better outcomes and more lasting benefits,” senior investigator Paul Sponseller, MD, stated in a press release from John Hopkins Medical Institutions.

Sponseller and colleagues with the Johns Hopkins Children’s Center assessed the pelvic angles and transverse plane symmetry of 27 consecutive patients with scoliosis and severe cerebral palsy who underwent CT for spinal surgery. According to the study abstract, the investigators used a program that allowed for measurement of angles in the true transverse plane, which compensated for obliquity. Measurements taken included angles of the upper and lower ilium with respect to the sacrum, acetabular anteversion and sacroiliac joint angles. Twenty age-matched controls were also measured using the parameters.

The investigators found that all of the patients with cerebral palsy displayed “significantly more” iliac angle asymmetry and asymmetry of at least 10° in the following categories:

• upper ilium;
• above the sciatic notch;
• just below the sciatic notch;
• the sacroiliac joint; and
• acetabular anteversion.

None of the individuals in the control group displayed asymmetry greater than 10°, according to the study.

The investigators found that 85% of the children with cerebral palsy also had windswept hips. Children with windswept hips had more pronounced pelvic asymmetry than those without the feature, according to the press release.

Reference:

• Ko PS, et al. Transverse-plane pelvic asymmetry in patients with cerebral palsy and scoliosis. J Pediatr Orthop. 2011 Apr-May;31(3):277-283.

Disclosure: No relevant financial disclosure has been reported.

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