Neuromuscular Scoliosis- Orthopedics, Spinal Surgery

Neuromuscular scoliosis is a type of spine deformity. It causes the spine to curve to either right or left side. This occurs when the muscles that support the spine become weak or the nerves that control these muscles do not function properly.

Usually, neuromuscular scoliosis begins in childhood and continues to progress throughout life. In fact, the rate of progression is more rapid compared to other types of scoliosis. The affected child has “long C-shaped” curve in the spine. The curve begins in the chest region and can continue up to the pelvis.

It is more likely to occur in children with certain neuromuscular diseases. For example, cerebral palsy, muscular dystrophy and neurofibromatosis.

Children with neuromuscular scoliosis have problems with sitting, walking, using hands, and performing daily activities. Moreover, severe spine curvature often causes breathing difficulties and problems with heart function.

How is neuromuscular scoliosis diagnosed?

The diagnosis typically involves three steps.

First, the doctor will review your child’s medical history. They may ask questions about the child’s nutritional status, growth pattern, and their ability to perform daily activities.

Second, they will examine how the child walks, breathes, and moves hands. Additionally, they may also check if the child has normal reflexes and abnormal sensations like numbness.

Based on these findings, the doctor may categorize your child as a:

• Walker
• Sitter
• Nonsitter

Third, they can ask for certain blood tests and imaging tests.

Blood tests for neuromuscular scoliosis

The blood tests reveal the nutritional status of the child. This is critically important because a malnourished child can have problems with wound healing and infection following a corrective surgery.

The commonly employed tests determine the white blood cells, hemoglobin, electrolytes, and proteins.

Imaging tests for neuromuscular scoliosis

Either a plain X-ray or an MRI (magnetic resonance imaging) or both may be recommended.

In most cases, plain X-rays of the spine are enough to determine the severity of curvature. The choice of the X-ray technique depends on whether the child is able to sit or stand.

MRI uses strong magnets and radio waves to produce detailed images of the organs.

Additional Test

Your doctor will likely order a test to determine the lung function before a corrective surgery.

Treatment of neuromuscular scoliosis: Things to know

Surgery is the ultimate treatment. It helps to slow down the disease progression and improve quality of life. Nonetheless, bracing might be beneficial in those with mild curvature.

Sources:

• https://www.sciencedirect.com/topics/medicine-and-dentistry/neuromuscular-scoliosis
• https://emedicine.medscape.com/article/1266097-overview
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261245/

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