Hopkins Children's study finds some patients with cerebral palsy have asymmetric pelvic bones
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.
Related:
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
Media Contact
More Information:
http://www.jhmi.eduAll latest news from the category: Studies and Analyses
innovations-report maintains a wealth of in-depth studies and analyses from a variety of subject areas including business and finance, medicine and pharmacology, ecology and the environment, energy, communications and media, transportation, work, family and leisure.
Newest articles
New yttrium-hydrogen compounds discovered
Researchers at the University of Bayreuth have made a significant scientific breakthrough by discovering new yttrium-hydrogen compounds having serious implications for the research on high-pressure superconductivity. High-pressure superconductivity refers to…
New AI model detects ninety percent of lymphatic cancer cases
Medical image analysis using AI has developed rapidly in recent years. Now, one of the largest studies to date has been carried out using AI-assisted image analysis of lymphoma, cancer…
UTA preps giant particle detectors for neutrino project
Excavation of caverns part of Fermilab’s Deep Underground Neutrino Experiment. With excavation work complete at the site where four gigantic particle detectors for the international Deep Underground Neutrino Experiment (DUNE) will be…