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 less than 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.