# A Traffic Light System for Detecting Spinal Deformities in Children with Cerebral Palsy

## TL;DR

The TLS-Spine is a user-friendly tool that helps pediatricians and physiotherapists detect spinal deformities in children with cerebral palsy and decide on further care.

## Contribution

The TLS-Spine is a novel traffic light system designed to improve early detection of spinal deformities in children with cerebral palsy.

## Key findings

- The TLS-Spine was correctly applied in 96.3% of cases by 48 participants.
- Reviewers found the tool straightforward, not time-consuming, and helpful for clinical decision-making.
- Physicians rated the TLS-Spine higher than physiotherapists in four of nine dimensions.

## Abstract

What are the main findings?
The TLS-Spine is an easy-to-use tool for pediatricians and physiotherapists in daily clinical routine for getting an impression of the condition of the spine in CP children.It helps clinicians to perform a clinical examination, to understand the findings and to decide on further management of the patients.

The TLS-Spine is an easy-to-use tool for pediatricians and physiotherapists in daily clinical routine for getting an impression of the condition of the spine in CP children.

It helps clinicians to perform a clinical examination, to understand the findings and to decide on further management of the patients.

What is the implication of the main finding?
The TLS-Spine may increase the awareness for spinal deformities in CP children and enables early referral to orthopedic specialists for early detection and treatment.

The TLS-Spine may increase the awareness for spinal deformities in CP children and enables early referral to orthopedic specialists for early detection and treatment.

Background/Objectives: Currently, clinicians and physiotherapists pay only limited attention to spinal deformities in children with cerebral palsy (CP). To enhance awareness, a tool based on a traffic light system (TLS-Spine) was developed for use by pediatricians and physiotherapists caring for children with CP. The objective of the study was to evaluate the applicability of this assessment tool in routine clinical practice. Methods: A review group consisting of 48 pediatricians and physiotherapists was recruited. Each participant was asked to apply the TLS-Spine to a minimum of 10 CP patients and to complete a questionnaire concerning its value and applicability in daily practice. Responses were rated on a scale from 1 (complete agreement) to 6 (complete disagreement). Results: The TLS-Spine was correctly applied in 96.3% cases. The questionnaires of 48 reviewers based on 537 completed survey sheets were analyzed. Overall, reviewers reported no difficulties with the introduction and use of the TLS-Spine in daily clinical routine practice (median/range: 1/1–4). The tool was considered straightforward to use (1/1–3), not time consuming (1/1–4), helpful in performing the clinical examination (2/1–6), understanding the findings (2/1–6) and deciding on further management of the patients (2/1–5). Physicians rated the TLS-Spine significantly higher than physiotherapists in four of nine dimensions. Conclusions: The TLS-Spine is a practical and user-friendly assessment tool. It may increase the awareness for spinal deformities and support early referral to orthopedic specialists for early detection and treatment.