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Neuromuscular Diseases

 

Neuromuscular scoliosis is a condition characterized by abnormal curving of the spine due to asymmetrical myoneural (muscle-nerve) pathways in the body. The spine may appear twisted to form a multidimensional curve. In the long-term, this spinal deformity may affect pulmonary function and decrease overall physical activity. Neuromuscular scoliosis is commonly associated with cerebral palsy (neuromuscular condition caused by an injury to the immature brain) in children.

Causes

Neuromuscular scoliosis is generally caused due to neurological problems and weak muscle control. Cerebral palsy is a neuromuscular disease which affects both muscles and nerves of the children. The symptoms of cerebral palsy such as spasticity (stiff or rigid muscles), ataxia (loss of balance), athetosis (uncontrolled twisting of hands and legs), and hypotonia (poor muscle tone) together corresponds to the cause of neuromuscular scoliosis.

Symptoms

The most common symptoms of neuromuscular scoliosis are inability to sit, changes in the child’s posture, uneven shoulder height and uneven hip height. Your child may tend to lean towards one side while standing and walking, and may use their arms as a support to sit.

Diagnosis

The doctor may recommend X-ray’s as a primary diagnosis for your child’s condition. Pulmonary function tests may be necessary to determine the function of the lungs. EOS imaging, MRI, CT scan or ultrasound may be advised to evaluate the internal body structures and muscle deformities.

Treatment

The treatment of neuromuscular scoliosis can be non-surgical or surgical methods.

The doctor might recommend non-surgical treatment options if the curve is small. Treatments such as physical therapy, using braces on the back to support the spine and wheelchair modifications may aid in the management of neuromuscular scoliosis to some extent and help to improve your child’s quality of life.

The surgical treatment option for neuromuscular scoliosis depends on your child’s age, stage of growth and degree of spinal curve. The commonly performed spine surgeries are spinal fusion, implantation of vertical expandable prosthetic titanium rib (VEPTR) and growing rods. VEPTR and growing rods can help stabilize and straighten the curved spine and also resolve any rib cage complications. Your child would have to return to

the hospital every six to twelve months for a minor surgery to adjust (lengthen or expand) the implanted device until skeletal maturity. Spinal fusion is generally performed on children who have stopped growing. The surgery is done to correct the abnormally curved spine by realigning and fusing the vertebrae together with the help of metal implants. The spinal fusion helps provide stability to the spine. Post-operative physical rehabilitation procedures may be advised for a faster recovery.

California Institute of Neuroscience

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