Images in clinical medicine | Volume 36, Article 242, 04 Aug 2020 | 10.11604/pamj.2020.36.242.24971

Lordoscoliosis and hyperlordosis in quadriplegic cerebral palsy

Chanan Vivek Goyal, Waqar Mohsin Naqvi

Corresponding author: Waqar Mohsin Naqvi, Community Health Physiotherapy Department, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India

Received: 13 Jul 2020 - Accepted: 26 Jul 2020 - Published: 04 Aug 2020

Domain: Physical medicine and rehabilitation or Physiatry, Pediatrics (general), Community health

Keywords: Cerebral palsy, lordoscoliosis , pediatrics deformities, hyperlordosis, posture

©Chanan Vivek Goyal et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Chanan Vivek Goyal et al. Lordoscoliosis and hyperlordosis in quadriplegic cerebral palsy. Pan African Medical Journal. 2020;36:242. [doi: 10.11604/pamj.2020.36.242.24971]

Available online at: https://www.panafrican-med-journal.com/content/article/36/242/full

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Images in clinical medicine

Lordoscoliosis and hyperlordosis in quadriplegic cerebral palsy

Lordoscoliosis and hyperlordosis in quadriplegic cerebral palsy

Chanan Vivek Goyal1, Waqar Mohsin Naqvi2,&

 

1Government Physiotherapy College, Raipur, Chhattisgarh, India, 2Community Health Physiotherapy Department, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India

 

 

&Corresponding author
Waqar Mohsin Naqvi, Community Health Physiotherapy Department, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India

 

 

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A 7-year-old female, born out of a non-consanguineous marriage, presented with an extreme posturing of the spine. As per her father, she had a history of delayed birth cry and recurrent episodes of seizures. She was diagnosed with quadriplegic cerebral palsy with epilepsy. She was referred by an orthopedic surgeon to the department of physiotherapy for evaluating if the spinal deformity was fixed or flexible, so that the further line of management could be determined. On observation of her posture in supine lying (A) and in prone lying (B), marked lordoscolios was noted along with hyperlordosis. Examination revealed spasticity of grade 3 on the modified Ashworth scale (MAS) in spinal extensor muscle group. She was neither able to roll over nor was she able to sit even with extensive support. The posturing of the spine posed difficulties for caregivers during feeding, dressing and during activities to maintain hygiene. In an attempt to examine flexibility of the spine, child was placed prone on the lap by the physiotherapist. Slow vestibular stimulus in the form of rocking movements was given by the movement of the physiotherapist´s thighs. As the child displayed some relaxation of trunk muscles, the physiotherapist clasped her hands below her knees providing a firm pressure to the child´s back through her arms. This further inhibited the resistance offered by the child´s muscles and the spine could be aligned to near neutral in the sagittal as well as in the coronal plane revealing the flexible nature of the deformity (C).

 

 

Figure 1: A) posture in supine lying; B) in prone lying, marked lordoscoliosis along with hyperhidrosis; C) is showing the spine alignment to near neutral in the planes revealing the flexible nature of the deformity

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

Lordoscoliosis and hyperlordosis in quadriplegic cerebral palsy

Images in clinical medicine

Lordoscoliosis and hyperlordosis in quadriplegic cerebral palsy

Images in clinical medicine

Lordoscoliosis and hyperlordosis in quadriplegic cerebral palsy

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Key words

Cerebral palsy

Lordoscoliosis

Pediatrics deformities

Hyperlordosis

Posture

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Lordoscoliosis and hyperlordosis in quadriplegic cerebral palsy