Relationship between severity and thoracic deformity in children (persons) with severe motor and intellectual disabilities, and its characteristics.

Abstract

Thoracic deformity in patients with severe motor and intellectual disabilities (SMID) was measured by CT imaging, and the following two points were considered, 1) Is there any relation between the sevelity of thoracic deformity and of clinical state?, and 2) How does the thoracic deformity change according to the measuring level? 30 patients with SMID (average age 41.1±9.3 years, 17 men and 13 women) were targeted. The severity was classified into two groups, level IV and level V, by Gross Motor Function Classification System-Expanded and Revised-Japanese edition (GMFCS-ER). CT imaging at three different thoracic level were set as the target images. Each parameter, 1) spinal rotation, 2) thoracic rotation, and 3) thoracic flattening, which consists of thoracic deformity, was measured in each image. According to the results, in the group with GMFCS-ER level V, the degree of thoracic deformity is more severe. And for both level IV and V groups, as the measuring level becomes lower, the deformity gets more severe, but it also is suggested that the changing pattern of parameters in each group differs. From this, characteristics of three-dimensional twist of thoracic deformity differ depending on severity, and evaluation of thoracic deformity at multiple level is thought to be important in determining the cause of the clinical symptoms as well.