Neuromuscular Scoliosis

This type of scoliosis is due to some abnormality in the nervous or muscular systems which leads to abnormal development, growth and balance of the spine. This may be due to altered muscle forces and support of the spine or a neurologic mechanism causing abnormal spinal alignment and balance. Over time, and particularly in a growing adolescent or child, the abnormal neurologic/muscular function can lead to gradual deformity of the spinal column and orientation of the pelvis (pelvic obliquity may develop). In addition to the development of scoliosis, an alteration in the normal curvatures of the spine, when seen from the side, may occur causing increased or decreased lordosis (lumbar) or kyphosis (thoracic). Some of the more common diseases or conditions that lead to neuromuscular scoliosis include: cerebral palsy, paralytic conditions, muscular dystrophies/myopathies, myelomeningocoele, brain injuries and spinal cord anomalies and tumors.

A patient with a neuromuscular type spine deformity must be treated in a team approach. It is very important to treat the entire condition of the patient and not focus only upon the scoliosis. In patients who are severely handicapped from their neuromuscular condition (ex. Cerebral palsy, paralysis, genetic disorder, myopathy? the most important treatment for their spine may be to ensure comfortable sitting and avoidance of pressure sores. To treat this properly, a close collaboration with therapists and orthotists (brace specialists) is essential. If the spinal deformity is severe, surgery may offer good correction of deformity and offer a stable spine which permits comfortable sitting. In patients who are ambulators (able to walk) treatment will focus on pain relief and balance so that the patient can use his arms independently from supporting a curved spine. With severe or worsening spinal curvature surgery can lead to better spinal balance and thus better walking ability. Most importantly, any spinal treatment in people suffering from a neuromuscular condition or cerebral palsy will require close collaboration between physical therapists, general physicians, orthotists and nursing staff. It is essential to carefully adapt any treatment to the abilities and goals of the particular patient.

Frequently Asked Questions