Setting: Tertiary care pediatric hospital. Patient: A 15-year-old boy with spastic quadriplegic cerebral palsy (CP) due to presumed hypoxic
ischemic encephalopathy. Case Description: Botulinum toxin type A (BTX-A) was used to treat scoliosis due to spasticity. The
patient had levoscoliosis of the thoracolumbar spine from T7 to L3 with its apex at
the T12 region. Scoliosis became progressive to the point where the patient had to
wear a thoracolumbosacral orthosis at night to prevent arching to the left side and
a recommendation of posterior spinal fusion by an orthopedic surgeon was made. On
physical examination, his paraspinal muscles from midthoracic to low lumbar area were
significantly tight. Total of 300U of BTX-A was injected into the paraspinal muscles
of T9-L5 spine in multiple areas under nerve stimulator guidance. Assessment/Results: Patient’s scoliosis improved 22° from 55° to 33° on follow-up spine radiograph at
3 weeks BTX-A injections were given. His sitting and lying postures were also significantly
improved where he did not have to wear a thoracolumbosacral orthosis at night anymore.
Discussion: Currently, BTX-A injections are accepted practice to treat spasticity in the limbs.
This case report is important to address the possible use of BTX-A in scoliosis due
to spasticity. Conclusions: BTX-A will be beneficial to prevent further progression of scoliosis due to spasticity.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Article info
Footnotes
Disclosure: None.
Identification
Copyright
© 2005 Published by agreement with the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
