Introduction

Posterior spinal arthrodesis with thoracoplasty and an open anterior approach, with respect to a posterior only fusion, have a deleterious effect on pulmonary function for up to 5 years after surgical treatment of adolescent idiopathic scoliosis. We aimed to compare two groups of adolescents surgically treated for their spinal deformity either by posterior segmental fusion alone (PSF) or by posterior spinal fusion and thoracoplasty (PSF+T). We focused on the long-term effects of thoracoplasty on pulmonary function in the surgical treatment of adolescent idiopathic scoliosis.

Aims: The aim of this study is to evaluate the effectiveness of a treatment with botulinum toxin type A (BTX-A) in children affected by CP. Methods: Between May 2001 and July 2002, we treated 12 children affected by CP: 11 males, 1 female, mean age 6,42 years; 1 child suffered from tetraplegia, 5 from diplegia and 6 from emiplegia. The injection was carried out in gastrocne-mius muscle (medial and lateral) in 11 patients, in hamstrings in 1 patients in a dose of 6 Units per kg of body weight per muscle. Post-injective treatment included intense physical therapy and orthoses. A clinical and video-recording evaluation, Gross scale and gait-EMG were carried out before injection and 1,3,6 months after. Results: BTX-A treatment has a good functional result: at the þrst control after injection all patients had a complete foot-ground contact instead of toe contact during stance and gait. Conclusion: The results of BTX-A treatment are positive, accordingly to literature: in all patients there was a reduction of spasticity and a complete foot-ground contact, with functional improvement in stance and gait. Good results can be achieved only if the indication is correct: spasticity of the muscle without muscle-tendinous retraction. BTX-A treatment has an effective role in the management of children suffering from CP, where there is no indication for surgical treatment.