Using spinal cord deformation‐based morphometry to improve our understanding of motor potential and outcomes in children with cerebral palsy

The International Classification of Functioning, Disability and Health (ICF) was officially endorsed by the World Health Organization on 22nd May 2001, during the 54th World Health Assembly.Since that time, clinicians, researchers, and teachers have utilized the framework when developing treatment plans, framing their research, and teaching students.Healthcare providers delivering care to children with cerebral palsy (CP) are all too familiar with assessing body structures and function, and addressing impairments.We have been encouraged to expand our focus and address limitations in activities and participation.The article by Latypov et al. 1 takes us back to the importance of body structure and function.While most of the literature in children with CP has examined muscle, brain, and bone, to my knowledge there has been no examination of the spinal cord in children with CP to date.I admit I was not familiar with the spinal cord deformation-based morphometry (scDBM) approach 2 used by Latypov et al. and was challenged to read and learn about it to understand the findings.What I learned was that others have applied these methods to adults showing differences in both total spinal cord cross-sectional area and gray matter cross-sectional area.3 In addition, altered sensorimotor cortical activity seen in CP may result in changes within the spinal cord microstructure and contribute to sensorimotor deficits in adults with CP. 4 We do not know when these changes begin to occur in the lifespan of those with CP and understanding spinal cord morphometry in children is where we should start.This study by Latypov et al. is therefore important as they used these methods not previously applied to children with CP, to identify structural signatures of CP severity and selective dorsal rhizotomy (SDR) outcomes using a spinal cord