Trentin L1, Valagussa G1,2, Grossi E1
1Villa Santa Maria Foundation, Tavernerio, Italy, 2Università degli Studi di Milano-Bicocca, Milano, Italy
Background: The function of the vertebral column is to support man in upright positions, mechanically balance to conform to the stress of gravity, permit locomotion and assist in purposeful movements. The term “spinal deformity” includes conditions such as post-traumatic deformities, iper-kyphosis, iper-lordosis and idiopathic adolescent scoliosis. Severe spinal curvatures may be associated with adverse long-term health outcomes (e.g. pulmonary disorders, disability, back pain, psychological effects, and reduced quality of life). Early identification and effective treatment of mild scoliosis could slow or stop curvature progression before skeletal maturity, thereby improving long-term outcomes in adulthood. There is scientific evidence to support the value of spinal deformity screening. Autism Spectrum Disorder (ASD) is a child-onset chronic neurodevelopmental condition characterized by core impairments in social/communication and repetitive behaviors. Children with ASD have impairments in fine and gross motor skills, motor planning, motor coordination and praxis. Moreover individuals with ASD demonstrate different patterns of postural control. Since in clinical settings we recognized the presence of spinal alignment alterations in some developing ASD subjects, we were interested in understanding the state of the art about assessment and treatment of spinal deformities in these patients.
Purpose: The aim of this systematic review is to critically describe what is the current knowledge about spinal deformities in ASD subjects in terms of prevalence, assessment methods and treatment.
Methods: The systematic review protocol was previously registered on PROSPERO database (registration number CRD 42018100894). We conducted an extensive literature search in PubMed, CINAHL, PsycINFO, The Cochrane Library, and Scopus databases. We also considered grey literature sources such as: Opengray, Penn Libraries and International Society for Autism Research (INSAR) Congress archives. There were no restrictions on the types of study design eligible for inclusion, publication date or language. The main keywords used were: ASD, Autism, Autistic Disorder, Spinal deformities, Scoliosis and Spine.
Results: Following the PRISMA statement study selection process we screened 2640 records after duplicates removal for eligibility. We found 11 eligible studies. All of them were excluded because the main object was not pertinent to our aim. The main topics found were genetics, spinal surgery or surgery outcomes, since ASD is used in literature also as the acronym of Adult Spine Deformity.
Conclusion(s): Spinal deformities appear as an understudied topic in autism research. At present, in all the literature screened, there is no evidence about prevalence, assessment methodology and treatment of spinal deformities in ASD subjects. Since adolescent idiopathic scoliotic curves typically progress most rapidly during adolescent growth and since in a clinical setting is possible to find developing ASD subjects presenting with spinal deformities, it becomes important to conduct studies to verify the applicability of screening protocols in developing ASD subjects.
Implications: This systematic review supports the importance of conducting studies in order to verify the applicability of a spinal deformity screening protocol in ASD subjects.
Keywords: Spinal deformities, autism spectrum disorder, systematic review
Funding acknowledgements: The work was unfunded.
Purpose: The aim of this systematic review is to critically describe what is the current knowledge about spinal deformities in ASD subjects in terms of prevalence, assessment methods and treatment.
Methods: The systematic review protocol was previously registered on PROSPERO database (registration number CRD 42018100894). We conducted an extensive literature search in PubMed, CINAHL, PsycINFO, The Cochrane Library, and Scopus databases. We also considered grey literature sources such as: Opengray, Penn Libraries and International Society for Autism Research (INSAR) Congress archives. There were no restrictions on the types of study design eligible for inclusion, publication date or language. The main keywords used were: ASD, Autism, Autistic Disorder, Spinal deformities, Scoliosis and Spine.
Results: Following the PRISMA statement study selection process we screened 2640 records after duplicates removal for eligibility. We found 11 eligible studies. All of them were excluded because the main object was not pertinent to our aim. The main topics found were genetics, spinal surgery or surgery outcomes, since ASD is used in literature also as the acronym of Adult Spine Deformity.
Conclusion(s): Spinal deformities appear as an understudied topic in autism research. At present, in all the literature screened, there is no evidence about prevalence, assessment methodology and treatment of spinal deformities in ASD subjects. Since adolescent idiopathic scoliotic curves typically progress most rapidly during adolescent growth and since in a clinical setting is possible to find developing ASD subjects presenting with spinal deformities, it becomes important to conduct studies to verify the applicability of screening protocols in developing ASD subjects.
Implications: This systematic review supports the importance of conducting studies in order to verify the applicability of a spinal deformity screening protocol in ASD subjects.
Keywords: Spinal deformities, autism spectrum disorder, systematic review
Funding acknowledgements: The work was unfunded.
Topic: Paediatrics; Musculoskeletal: spine
Ethics approval required: No
Institution: University of Milano Bicocca
Ethics committee: Research Ethics Committee of the University of Milano Bicocca
Reason not required: It is a systematic review.
All authors, affiliations and abstracts have been published as submitted.
