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Neuromuscular Scoliosis

If your child is suffering from neuromuscular scoliosis, your main goal is finding the proper treatment to allow him or her to thrive. This curvature of the spine, often found in conjunction with other conditions, can be successfully treated to give your child the chance to lead a more normal life.

About Neuromuscular Scoliosis

When neuromuscular scoliosis occurs, the muscles and nerves have difficulty keeping the spine properly aligned. In many cases, these curvatures are found in conjunction with a condition known as pelvic obliquity, where the pelvis tilts up to one side, throwing the spine out of alignment.

Symptoms of Neuromuscular Scoliosis

Children with neuromuscular scoliosis can exhibit a number of symptoms. They can be subtle or quite pronounced, depending on the severity of the curvature and whether or not other systems are being impacted by this condition.

If your child has neuromuscular scoliosis, you may note the following:

  • Balance may be affected and is most notable when your child is walking (if they walk). Maintaining balance while sitting can also be a challenge.
  • Difficulty breathing due to severe curvatures that interfere with lung development.
  • Visible asymmetry – this includes one shoulder sitting on a greater level than the other, a “tilt” in the rib cage or a waist that gives the appearance of being noticeably much higher on one side.
  • When your child walks you may notice an abnormal posture, uneven gait or difficulty in trying to stand upright.
  • In the case of children that do not walk, signs can include the need to support themselves with their arms while sitting or leaning severely to one side.
  • Pain is rare in this condition, but your child may experience some mild back pain.

Diagnosis of Neuromuscular Scoliosis

If you suspect your child may be suffering from neuromuscular scoliosis, it’s important that you get an assessment to also rule out other possibilities. Diagnosing this condition is fairly straightforward. Your child’s doctor will perform a physical exam and may ask a series of questions to shed some light on what might be going on.

X-rays are then used to view and measure the spine and its curvatures. The rotation of the pelvis is also measured to assess the severity of the issue. These X-rays will be taken without support so as to allow the doctors to see the full extent of the curve, allowing gravity to pull down and fully reveal the spine’s unsupported shape.

Treatment Options for Neuromuscular Scoliosis

Neuromuscular scoliosis can be treated both surgically and non-surgically. The treatment recommended will be based on the severity of the curve, the health status of your child and other factors such as age.

In cases where a non-surgical approach is used, physical therapy is almost always recommended. This helps strengthen surrounding muscles and keeps your child fit. Other methods include bracing for mild curves to encourage the spine to grow straighter. For children that don’t walk, wheelchair modifications can be made to compensate for abnormalities and support posture that will allow the spine to remain straighter.

Surgically, the focus is to correct the curvature of the spine and then hold the spine in that position. This can be done with fixation devices such as growing constructs, which allow for adjustment as your child grows. Other surgical options can include fusion, in which portions of the spine are reinforced with bone grafts to help strengthen and stabilize the spinal structure. You and your child’s medical team can discuss the pros and cons of each option and determine together what would be most beneficial in your child’s particular case.