We talk a lot about adolescent idiopathic scoliosis because it is indeed the most common. However, there is another type that deserves our full attention: neuromuscular scoliosis.
This type of scoliosis is quite complicated because it occurs as a result of neurological or muscular disorders that affect the control of the muscles supporting the spine. Some causes of neuromuscular scoliosis include:
Cerebral Palsy: a condition that affects muscle control and movement, typically caused by brain damage that occurs before or during birth.
Muscular Dystrophy: a group of genetic diseases that gradually weaken the body's muscles.
Myelomeningocele: also known as Spina Bifida, is a neuromuscular condition where the spinal bones and the spinal cord do not form normally, resulting in a defect in the development of these structures. This leads to limited control over the muscles of the spine and lower limbs, causing scoliosis.
Spinal Cord Injuries: damage to the spinal cord due to accidents or traumas that can affect muscle function and postural control.
Polio: a viral disease that can affect motor nerves and lead to muscle weakness and paralysis.
I learned at the 2nd International AACD Scoliosis Symposium that neuromuscular scoliosis patients have some risk factors that require a lot of attention from the healthcare team, such as difficulty gaining weight, a higher propensity for skin lesions, slow wound healing, a greater risk of infection, intestinal dysfunction, a more tethered spinal cord, rapid curve progression, and significant functional impairment.
The treatment depends on a case-by-case basis, and the decision to perform surgery for patients with neuromuscular scoliosis is based on several factors, including the degree and progression of the curvature, the patient's age, the presence of symptoms and complications, the overall functional capacity of the patient, and the response to other conservative treatments. Surgery is usually considered when the deformity is severe and progressing rapidly or when the curvature is causing significant complications such as chronic pain, difficulty breathing, restricted mobility, impairment of heart function, or compression of internal organs. The decision to undergo surgery may also depend on the patient's age, as in cases of growing children, it may be essential to correct the curvature to prevent long-term health issues.
Before recommending surgery, doctors may try conservative approaches such as physical therapy, specific exercises, the use of braces or orthotics, and medications to control pain and inflammation. However, if these measures are not effective or if the curvature continues to worsen, surgery may be considered.
It is essential for the patient and their family to discuss all treatment options with a medical team specialized in neuromuscular scoliosis to make an informed decision. Each case is unique, and the choice to proceed with surgery will depend on the patient's specific characteristics, the severity of the condition, and the risks and benefits associated with the procedure.
I hope that with this post, I can provide you with important information about this serious condition that requires our attention!
Until next time, everyone!
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