Musculoskeletal Morbidity Among Adults Living With Spina Bifida and Cerebral Palsy

Musculoskeletal Morbidity Among Adults Living With Spina Bifida and Cerebral Palsy.

Citation: Haapala HJ, Schmidt M, Lin P, Kamdar N, Mahmoudi E, Peterson MD. Musculoskeletal Morbidity Among Adults Living With Spina Bifida and Cerebral Palsy. Topics in Spinal Cord Injury Rehabilitation. 2022; 28(3):73-84.

Study type/Population:  A 4-year retrospective cohort study of national private insurance claims data for adults aged 18 and over with Cerebral palsy (CP) or Spina Bifida (SB) in the US; compared the incidence and risk for musculoskeletal (MSK) morbidities among those with CP or SB (15,302) and those without CP or SB (1,935,480).

Key Findings: Adults with CP or SB had higher 4-year incidence of most MSK conditions than those without CP or SB (55% vs 39%), including rheumatoid arthritis (3% vs 2%), osteoarthritis (20% vs 14%), osteoporosis (8% vs 5%), sarcopenia and weakness (11% vs 7%), other connective tissue diseases (53% vs 36%) and myalgia (11% vs 7%). The risk of developing all MSK disorders was significantly greater in adults with CP or SB than in those without CP or SB even when adjusted for age, sex, race, education and household income factors.

Translation to Practice (what this paper adds): The incidence and risk of MSK disorders are higher in adults with CP/SB than in those without CP/SB. These results may even underestimate MSK disorders in those with CP/SB since this study only included adults with CP/SB who had private insurance, while most adults with CP/SB in the US have Medicaid and/or Medicare. To reduce the burden of MSK disorders among those with CP or SB, clinical awareness of MSK disorders, improved screening strategies, earlier interventions, and development of efficient referral resources for coordinated care are required in these high-risk population.