Johns Hopkins Children's Center researchers have discovered that most children with severe cerebral palsy have starkly asymmetric pelvic bones. The newly identified misalignment can affect how surgeries of the pelvis, spine and surrounding structures are performed, the researchers say.
The study will be published online on March 10 in the Journal of Pediatric Orthopaedics.
Previous studies of patients with cerebral palsy have reported asymmetry above the pelvis and misalignment of the hips, but this new report, the researchers say, is the first one to show misalignment between the two sides of the pelvic bone itself.
Most children with severe cerebral palsy have significant spinal curvatures (scoliosis) that often require surgery. Because the pelvis and the spine are connected, any surgical procedures to correct scoliosis should take into account the possibility of a misaligned pelvis, the investigators say. The degree of the asymmetry, they add, should dictate the size, type and placement of the surgical screws and rods used to stabilize the spine and pelvis in such corrective procedures.
"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," says senior investigator Paul Sponseller, M.D., chief of pediatric orthopedics at Hopkins Children's.
While performing surgeries to correct scoliosis, Sponseller started noticing a recurrent feature among his patients with severe cerebral palsy — a pronounced asymmetry between the left and right plates of the pelvic bone.
To quantify the problem, Sponseller performed three-dimensional CT scans on all of his cerebral palsy patients undergoing scoliosis surgery over one year. All 27 patients had asymmetric pelvises with misalignment of the pelvic bones was greater than 10 degrees. Comparing these images with pelvic-bone scans of children without cerebral palsy, the researchers noted that all of them had either no misalignment or only mild asymmetry of less than 10 degrees.
Twenty-three of the 27 children (85 percent) with cerebral palsy also had windswept hips, a hallmark feature in CP patients marked by one hip facing outward and the other one rotated inward. Children with windswept hips had more pronounced pelvic asymmetry than children without windswept hips, the researchers found.
Co-investigators on the research included Phebe Ko, B.S., Paul Jameson II, B.S., and Tai-Li Chang, M.D., all of Hopkins.
Hip, Thigh Implants Can Raise Bone Fracture Risk in Children http://www.hopkinschildrens.org/Hip-Thigh-Implants-Can-Raise-Bone-Fracture-Risk-in-Children.aspx
Paul Sponseller http://www.hopkinschildrens.org/Paul-Sponseller-MD.aspx
Ekaterina Pesheva | EurekAlert!
New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg
Disarray in the brain
18.12.2017 | Universität zu Lübeck
Physicists have developed a technique based on optical microscopy that can be used to create images of atoms on the nanoscale. In particular, the new method allows the imaging of quantum dots in a semiconductor chip. Together with colleagues from the University of Bochum, scientists from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute reported the findings in the journal Nature Photonics.
Microscopes allow us to see structures that are otherwise invisible to the human eye. However, conventional optical microscopes cannot be used to image...
On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.
We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...
What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...
For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.
Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...
At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.
No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...
08.01.2018 | Event News
11.12.2017 | Event News
08.12.2017 | Event News
23.01.2018 | Life Sciences
23.01.2018 | Earth Sciences
23.01.2018 | Physics and Astronomy