One of the symptoms present in older children afflicted with cerebral palsy includes spinal deformation, usually of a progressive natural deformation of the spinal cord due to dorsal muscle spasticity and hypertonia frequently associated with overwhelming majority of cerebral palsy patients. For cerebral palsy patients, who already are symptomatic of delayed growth complications, the loss of motor muscle control ultimately leads to atrophy in the muscles of cerebral palsy patients, who are otherwise enduring a period a spinal cord growth simultaneously. While percentage indicators depend largely on the type of cerebral palsy involved, which can include mixed types of cerebral palsy, the total cerebral palsy patient population experiences a near one in five chance of developing scoliosis as the child ages.
Cerebral Palsy and Early Spinal Cord Malformation
Due to irreversible brain damage sustained in utero, during the birthing process, or in the first few years of life, a child with cerebral palsy, depending on the type and severity, ultimately faces the prospect of requiring major surgical intervention at times to reverse or intervene to prevent further spinal cord damage commonly found in cerebral palsy patients. In every cerebral palsy patient, medical providers tasked with the overall care of the patient will consider the possibility to strong probability of future spinal or musculoskeletal deformation. In this sense, relatively non-invasive spinal cord damage treatments may resolve ongoing degradation of patient posture and spinal curvature, including:
- Chiropractic braces
- Medical devices promoting external support of the upper torso
- Lifestyle and wheelchair positioning changes
- Clinically-facilitated exercise of muscle groups experiencing deterioration
For the patient, however, most instances of cerebral palsy related spinal deformation are progressive in nature, and at best, non-invasive spinal cord alignment tactics will likely only delay the onset of further spinal curvature and pelvic obliquity in a large percent of patients.
Cerebral Palsy and Mild to Severe Spinal Cord Malformation
However, as cerebral palsy is a progressively worsening condition, the co-morbid spinal damage in patients generally continues proportional to ongoing atrophy of the patient’s muscles. Specifically, the muscle spasticity in cerebral palsy patients and the forced immobility of the patient leads to an otherwise generally devolving pattern of muscular and tissue degeneration ultimately impacting the curvature of the spine, among other concerns. For most cerebral palsy patients, spinal cord damage prevention, usually in the form of stabilizing patients already exhibiting scoliosis, is but one part of a multi-disciplinary individual patient healthcare program required by cerebral palsy patients.
At a certain point in the progression of cerebral palsy patient’s life, medical professionals frequently make the decision to alleviate either the impingement of the ribcage and costopelvic area, seek to cut down immobility complications alongside scoliosis coupled with pelvic obliquity spinal deteriorations, prevent further spinal misalignment and curvature, and ensure that cardiopulmonary complications due to spinal and thoracic cavity misalignment does not occur in cerebral palsy patients. In practice, the most effective and also highest risk approach to alleviating some spinal cord damages endured by cerebral palsy patients is found in surgical correction and fusion of misaligned vertebrae via a spinal arthrodesis surgical procedure seeking above all to stabilizing, if not slightly realign the trunk and spinal degeneration experienced by significant percentages of cerebral palsy patients.
Iatrogenic Spinal Cord Damage during the Perinatal and Postnatal Period
In limited instances, complications or trauma during the birthing process present increased risks for iatrogenic spinal damage to infant’s during the labor extraction process via blunt trauma or surgical mistakes. This damage to the spinal cord during an acute medical event for the infant presents the possibility of the patient exhibiting hypoxic-ischemic cerebral injury, which is frequently linked to the development of cerebral palsy later in young patients’ lives. Moreover, iatrogenic or misdiagnosed instances of spinal cord damage during the intrapartum period by attending gynecologists or obstetricians can result in fetal asphyxia, which once again is associated closely with the onset of cerebral palsy in infants, which in itself is closely associated with spinal cord deterioration and misalignment as common symptom of the condition.
Resources:
http://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/basics/definition/con-20023837
http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.4453213/k.7D62/Cerebral_Palsy.htm
https://www.nlm.nih.gov/medlineplus/spinalcordinjuries.html
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2856389/
