The Journal of Bone and Joint Surgery, Vol 63, Issue 9 1401-1411, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Spine deformity subsequent to acquired childhood spinal cord injury
JK Mayfield, JC Erkkila and RB Winter
The cases of forty children who had incurred a spinal cord injury between
birth and the age of eighteen years were reviewed at two to 26.8 years
(mean, ten years) after injury. In all of the twenty-five patients who were
injured prior to the adolescent growth spurt paralytic spinal deformity
developed; in twenty-four (96 per cent) of them it was progressive.
Scoliosis developed in twenty-three (92 per cent); kyphosis, in sixteen (64
per cent); and excessive lumbar lordosis, in five (20 per cent). Management
of the spinal deformities by bracing was difficult, and seventeen patients
(68 per cent) required spine fusion, usually to the sacrum. Complications
were frequent. All of the fifteen patients who were injured after the onset
of the adolescent growth spurt had sustained a spinal fracture or
fracture-dislocation. Nine (60 per cent) had an acute angular thoracic or
thoracolumbar fracture kyphosis and seven (47 per cent) had progressive
fracture kyphosis. A history of a thoracic and thoracolumbar laminectomy
always was associated with increased kyphosis progression. Six (40 per
cent) of these patients required spinal stabilization, usually for unstable
injuries and progressive post-laminectomy deformity. Progressive paralytic
spinal deformity was uncommon in the postadolescent patient.
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