Surgical and health outcomes of non‐ambulatory children with cerebral palsy and severe scoliosis: A population‐based, longitudinal study

Aim To evaluate medium‐term surgical outcomes, complications, mortality, and health‐related quality of life (HRQoL) in non‐ambulatory children with cerebral palsy (CP) and severe scoliosis, and to analyse outcomes and mortality rates in children who had not undergone surgery. Method Data on non‐ambulatory children with CP and severe scoliosis born from 2002 to 2008 were extracted from the Norwegian Quality and Surveillance Registry for Cerebral Palsy. Seventy‐five children (44 males, 31 females) were included. Thirty‐eight (51%; mean age at surgery 14 years 4 months; SD = 2 years 4 months; range = 8–18 years) underwent surgical correction and posterior spinal fusion, with a mean preoperative Cobb angle of 90° (range = 49°–140°), while 37 (49%) children had non‐surgical treatment. HRQoL was measured with the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD). Results Eighteen children (47%) had postoperative complications; 5 of 38 (13%) children underwent further surgery. Surgical treatment improved sitting posture and back pain. The mean CPCHILD score was 49.0 (range = 19–84). Among non‐surgically treated children, 15 of the 31 children considered too fragile to undergo spinal surgery (48%) died during the follow‐up; the mean CPCHILD score for the remaining children was 36.4 points (range = 9–59). Interpretation Although surgical correction of scoliosis in non‐ambulatory children with CP carried a high risk of complications and re‐operations, it resulted in improved sitting posture and reduced back pain. Children who were not eligible for surgical treatment had a high mortality rate.