ERECTOR SPINAE AND SCOLIOSIS IN A POPULATION WITH CEREBRAL PALSY: A PRELIMINARY STUDY

ALÍ-MORELL, OSAMA J.; ZURITA-ORTEGA, FÉLIX; FERNÁNDEZ-ESTÉVEZ, BERENICE; PADILLA-OBISPO, BEATRIZ; MARTÍNEZ-PORCEL, ROBERTO

doi:10.1590/S1808-185120181701155345

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ORIGINAL ARTICLE • Coluna/Columna 17 (01) • Jan-Mar 2018 • https://doi.org/10.1590/S1808-185120181701155345 copy

ERECTOR SPINAE AND SCOLIOSIS IN A POPULATION WITH CEREBRAL PALSY: A PRELIMINARY STUDY

ERECTOR DA ESPINHA E ESCOLIOSE EM UMA POPULAÇÃO COM PARALISIA CEREBRAL: ESTUDO PRELIMINAR

MÚSCULO ERECTOR DE LA COLUMNA Y ESCOLIOSIS EN UNA POBLACIÓN COM PARÁLISIS CEREBRAL: ESTUDIO PRELIMINAR

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To verify the relation of muscular response to the vestibular stimulation of the erector spinae, specifically longissimus thoracis and iliocostalis lumborum, with the origin of scoliosis in a population of individuals with level V cerebral palsy of the Gross Motor Function Classification System (GMFCS).

Methods:

Cross-sectional study of 12 individuals aged between four and 14 years. The muscular activity of the longissimus thoracis and iliocostalis lumborum was recorded by electromyography in the presence of anteroposterior and lateral imbalances, comparing it with that obtained in sitting position without imbalances. Scoliosis was assessed by radiological study following Cobb method.

Results:

Statistically significant differences were found between correct responses of both muscles to anteroposterior imbalances and absence of right thoracolumbar scoliosis (p=0.005; p=0.028), left thoracic scoliosis (p=0.005; p=0.046) and right lumbar scoliosis (p=0.005; p=0.046).

Conclusions:

The symmetry of muscular responses to anteroposterior imbalances, both of longissimus thoracis and iliocostalis lumborum, seems to be one of the factors that prevent the development of spine deviations in this population. Level of evidence: IV. Type of Study: Case series

Keywords:
Cerebral palsy; Scoliosis; Muscles; Electromyography

	Type of curve	Cobb Angle	Lenke Classification
1	Left thoracolumbar	40º	5CN
2	Right thoracolumbar	55º	5CN
3	Left thoracolumbar	28º	5B+
4	Left thoracolumbar	30º	5B+
5	Left thoracolumbar	42º	5C+
6	Right thoracolumbar	38º	5C-
7	Left thoracolumbar	28º	5B+
8	Right thoracolumbar	25º	5BN
9	Right thoracic	32º	3AN
9	Left lumbar	26º	3AN
10	Right thoracolumbar	30	5BN
11	Right thoracic	35º	1A+
12	Right thoracic	40º	6C-
12	Left thoracolumbar	56º	6C-

Type of scoliosis		Frequency	Percentage
Right thoracolumbar	No	8	66.7%
Right thoracolumbar	Yes	4	33.3%
Left thoracolumbar	No	6	50%
Left thoracolumbar	Yes	6	50%
Right thoracic	No	9	75%
Right thoracic	Yes	3	25%
Left thoracic	No	12	100%
Left thoracic	Yes	0	0%
Right lumbar	No	12	100%
Right lumbar	Yes	0	0%
Left lumbar	No	11	91.7%
Left lumbar	Yes	1	8.3%

Right thoracolumbar scoliosis and response of the longissimus thoracis to the lateral imbalance
Right thoracolumbar scoliosis				LLT (µ Lat)
Right thoracolumbar scoliosis				Insufficient response	Correct response
No	RLT (µ Lat)	Insufficient response	Count	3	0
		Insufficient response	% No scoliosis	37.5%	0%
		Correct response	Count	1	4
		Correct response	% No scoliosis	12.5%	50%
Yes	RLT (µ Lat)	Insufficient response	Count	1	1
		Insufficient response	% Yes scoliosis	25%	25%
		Correct response	Count	1	1
		Correct response	% Yes scoliosis	25%	25%
Significance for “No scoliosis” p= 0.028**

Scoliosis and the response of the lumbar iliocostalis to anteroposterior imbalance
Right thoracolumbar scoliosis				LIC (µ AP)
Right thoracolumbar scoliosis				Insufficient response	Correct response
No	ICdrcho (µ AP)	Insufficient response	Count	3	0
		Insufficient response	% No scoliosis	37.5%	0%
		Correct response	Count	1	4
		Correct response	% No scoliosis	12.5%	50%
Significance for “No scoliosis” p= 0.028**
Escoliosis dorsolumbar izquierda
Yes	ICdrcho (µ AP)	Insufficient response	Count	2	0
		Insufficient response	% Yes scoliosis	33.3%	%
		Correct response	Count	0	4
		Correct response	% Yes scoliosis	%	66.7%
Significance for “Yes scoliosis” p= 0.014**
Left thoracic scoliosis
No	ICdrcho (µ AP)	Insufficient response	Count	3	0
		Insufficient response	% No scoliosis	25%	0%
		Correct response	Count	3	6
		Correct response	% No scoliosis	25%	50%
Significance for “No scoliosis” p= 0.046**
Right lumbar scoliosis
No	RIC (µ AP)	Insufficient response	Count	3	0
		Insufficient response	% No scoliosis	25%	0%
		Correct response	Count	3	6
		Correct response	% No scoliosis	25%	50%
Significance for “No scoliosis” p= 0.046**

Scoliosis and the response of the longissimus to anteroposterior imbalance
Right thoracolumbar scoliosis				LLT (µ AP)
Right thoracolumbar scoliosis				Insufficient response	Correct response
No	RLT (µ AP)	Insufficient response	Count	2	0
		Insufficient response	% No scoliosis	25%	0%
		Correct response	Count	0	6
		Correct response	% No scoliosis	0%	75%
Significance for “No scoliosis” p= 0.005**
Left thoracolumbar scoliosis
Yes	RLT (µ AP)	Insufficient response	Count	2	0
		Insufficient response	% Yes scoliosis	33.3%	0%
		Correct response	Count	0	4
		Correct response	% Yes scoliosis	0%	66.7%
Significance for “Yes scoliosis” p= 0.014**
Right thoracic scoliosis
No	RLT (µ AP)	Insufficient response	Count	3	1
		Insufficient response	% No scoliosis	37.5%	12,5%
		Correct response	Count	0	5
		Correct response	% No scoliosis	0%	62.5%
Significance for “No scoliosis” p= 0.018**
Left thoracic scoliosis
No	RLT (µ AP)	Insufficient response	Count	3	1
		Insufficient response	% No scoliosis	25%	8.3%
		Correct response	Count	0	8
		Correct response	% No scoliosis	0%	66.7%
Significance for “No scoliosis” p= 0.005**
Right lumbar scoliosis
No	RLT (µ AP)	Insufficient response	Count	3	1
		Insufficient response	% No scoliosis	25%	8.3%
		Correct response	Count	0	8
		Correct response	% No scoliosis	0%	66.7%
Significance for “No scoliosis” p= 0.005**
Left lumbar scoliosis
No	RLT (µ AP)	Insufficient response	Count	3	1
		Insufficient response	% No scoliosis	27.3%	9.1%
		Correct response	Count	0	7
		Correct response	% No scoliosis	0%	63.6%
Significance for “No scoliosis” p= 0.007**

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[1] Correspondence: Fundación Purísima Concepción, C/ Pedro Machuca 23. 18013 Granada. España fisiopurisima@gmail.com.