Affiliations: University of Edinburgh/Scottish National Spinal Deformity Centre, Royal Hospital for Sick Children, Edinburgh, UK
Correspondence:
[*]
Corresponding author: Athanasios I. Tsirikos, Scottish National Spinal Deformity Centre, Royal Hospital for Sick Children, Edinburgh, EH9 1LF, UK. Tel.: +44 0131 536 0784; Fax: +44 0131 536 0924; E-mail:thanos.tsirikos@nhslothian.scot.nhs.uk
Abstract: Neuromuscular scoliosis (NMS) is the second most prevalent spinal deformity
(after idiopathic scoliosis) and is usually first identified during early
childhood. Cerebral palsy (CP) is the most common cause of NMS, followed by
Duchenne muscular dystrophy (DMD). Progressive spinal deformity causes
difficulty with daily care, walking and sitting, and can lead to back and
rib pain, cardiac and pulmonary complications, altered seizure thresholds,
and skin compromise. Early referral to specialist spinal services and early
diagnosis of NMS is essential to ensure appropriate multidisciplinary
patient management. The most important goals for patients are preservation
of function, facilitation of daily care, and alleviation of pain.
Non-operative management includes observation or bracing for less severe and
flexible deformity in young patients as a temporising measure to provide
postural support. Surgical correction and stabilisation of NMS is considered
for patients with a deformity >40-50°, but may be performed for less
severe deformity in patients with DMD.
Post-operative intensive care, early mobilisation and nutritional supplementation aim to minimise the rate
of post-surgical complications, which are relatively common in this patient group.
However, surgical management of NMS is associated with good long-term
outcomes and high satisfaction rates for patients, their relatives and
carers.
