- Discussion: - preadolescents w/ spinal cord injury have >
95% prevalence of scoliosis & 50% of pts have a pelvic obliquity; - progressive kyphoscoliosis results from effects of gravity & loss of spinal musculature; - upto 2/3 of these patients will requre arthrodesis to prevent severe curve progression;
- Non Operative Treatment: - no evidence that bracing delays or prevents deformity during adolescence; - bracing may be helpful, in pts too young for surgery (10 yrs old); - if bracing is to be used, avoid using the Milwaukee brace in neuromuscular patients, because patients may hang on the neck piece;
- Operative Treatment: - delay surgery until pts are > 10 yrs old, unless pts progress w/ bracing; - procedure of choice is anterior and posterior arthrodesis w/ fusion down to
sacrum (because of pelvic obliquity); - surgery has a high incidence of pseudoarthrosis and infection; -
Luque rodding: -
Luque rodding (w/ anterior discectomies ant + post fusion) is solid enough to avoid need for bracing (which is poorly tolerated in spastic pts); -------------------------
Spine deformity subsequent to acquired childhood spinal cord injury. Paralytic spinal deformity following traumatic spinal-cord injury in children and adolescents.
Allograft bone in spinal fusion for paralytic scoliosis. 
