{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:31:06Z","timestamp":1790778666325,"version":"4.1.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2015,10,1]],"date-time":"2015-10-01T00:00:00Z","timestamp":1443657600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A triad of deformities\u2014thoracolumbar scoliosis, pelvic obliquity, and femoral head (hip) subluxation\/dislocation\u2014occurs frequently in non-ambulatory neuromuscular patients, but their close inter-relationship is infrequently appreciated or quantified. We propose a deformity documentation approach to assess each component simultaneously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The documentation assesses each component for maximal functional level, deformity, and flexibility\/rigidity: deformity from antero-posterior radiographs (scoliosis\u2014maximal functional position, pelvic obliquity\u2014sitting, hip position\u2014supine) and flexibility\/rigidity from extent of repositioning on supine (spine, pelvis) and frog lateral (hip) radiographs. The approach was applied in 211 patients: Duchenne muscular dystrophy (110), spinal muscular atrophy (49), cerebral palsy (26), and other neuromuscular disorders (26).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Measurement of 2124 radiological data points allowed for deformity (mild to moderate to severe) and flexibility\/rigidity (fully reducible to partially to non-reducible) gradations for scoliosis, pelvic obliquity, and hip subluxation\/dislocation. The charting documented: (1) numerical deformity and flexibility\/rigidity changes [ x-axis: age; y-axis: angulation (scoliosis and pelvic obliquity) and percent coverage (hip subluxation or dislocation) from 0\u2013120]; and (2) grade deformity and flexibility\/rigidity changes [ x-axis: age; y-axis: deformity and flexibility\/rigidity, following conversion of numerical measurements to a 1\u20135 grade scale]. In subgroups with the most extensive documentation, thoracolumbar and lumbar scoliosis extended into the sacrum with 98 % (114\/116) accompanied by pelvic obliquity; and scoliosis developed more rapidly than hip deformity in 44 % (28\/63), scoliosis and hip deformity developed at the same time in 40 % (25\/63), and hip deformity developed more rapidly than scoliosis in 16 % (10\/63) (Pearson's chi-squared test p = 0.0501, almost significant).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and significance<\/jats:title>\n                    <jats:p>Documentation of the triad of neuromuscular deformities is applicable to all diagnoses; it outlines maximal functional level, deformity, and flexibility\/rigidity at each site; and it shows the relationship between spine, pelvic, and hip deformation. Prospective charting will enhance both clinical management and clinical research into neuromuscular deformity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11832-015-0683-7","type":"journal-article","created":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T02:20:09Z","timestamp":1443579609000},"page":"345-356","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":49,"title":["Simultaneous progression patterns of scoliosis, pelvic obliquity, and hip subluxation\/dislocation in non-ambulatory neuromuscular patients: An approach to deformity documentation"],"prefix":"10.1177","volume":"9","author":[{"given":"Janki","family":"Patel","sequence":"first","affiliation":[{"name":"St. Louis, MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital, Boston, MA 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