Progression of scoliosis after skeletal maturity in institutionalized adults who have cerebral palsy

To study the natural history of scoliosis in institutionalized adults who have cerebral palsy, we reviewed retrospectively the cases of fifty-one patients. The patients were followed for at least four years (mean, 16.3 years; range, four to forty years) after they had reached skeletal maturity. The individuals in whom the curve eventually progressed the most had had the largest curves at the time of skeletal maturity. The rate of progression was 0.8 degree each year in the patients in whom the curve was less than 50 degrees at the time of skeletal maturity and 1.4 degrees in those in whom the curve was more than 50 degrees (p<0.04). The patients who had the largest curves at the time of skeletal maturity had spastic quadriplegia and either a thoracolumbar or a lumbar curve, and they were bedridden.