Thoracic Deformity in the Transverse Plane among Adults with Severe Cerebral Palsy

Abstract

[Purpose] Thoracic deformity (TD) secondary to severe kyphoscoliosis occurs frequently in adults with severe cerebral palsy (CP) and can eventually result in pneumonia. To determine the severity of TD, we used two protocols to examine and compare the anteroposterior (AP) and laterolateral (LL) diameters of the thorax in the transverse plane among adults with severe CP. [Subjects and Method] The study examined 20 adults with severe CP. Computed tomographic scans were acquired at the level of the xiphisternal junction in each patient, and two protocols were used to measure the AP and LL diameters. The largest AP diameters were measured along the gravity line (protocol 1) and along the line where the middle point of the sternum connects with the spinous process of the vertebra (protocol 2). The largest LL diameters were measured along the lines perpendicular to each AP diameter. The ratios of the AP to LL diameters were calculated. [Results] The AP diameter of protocol 1 was significantly shorter than that of protocol 2, and the LL diameter of protocol 1 was significantly longer than that of protocol 2. There was a significant difference in the ratio of AP to LL between the protocols. [Conclusions] Our results suggest that differences between protocols in the AP and LL diameters show the severity of TD.