Neuromuscular scoliosis is an abnormal curvature of the spine which is associated with disorders that affect the nerves and muscles. Some of the medical conditions that result in curving of the spine include cerebral palsy, muscular dystrophy, spinal cord injury, spinal bifida and polio.

Causes and Symptoms

Neuromuscular scoliosis is caused by muscle weakness, poor muscle control or paralysis in children. This condition worsens once the growth spurt occurs and makes it more difficult for the child to sit comfortably. Curving also reduces the lung space, leading to increased risk of pneumonia, breathing problems and obstruction of lung function.
Some of the signs that may be noticed in your child include:

• Uneven height of shoulders and hip
• Uneven buttocks
• Misalignment of head compared to rest of the body
• The left and right side of your child’s back appears at a different height when your child bends forward

Diagnosis

Neuromuscular scoliosis is diagnosed by physical examination, child’s medical and family history and a few diagnostic tests (X-ray, MRI scan, CT scan and bone scan) to confirm the condition.

Treatment

Non-surgical:

• Braces - Braces provide support to the trunk when the child is seated. Also, if your child is unable to walk because of the neuromuscular disease, then he will be treated with braces to control the curve as they grow. The children are also considered to be the best candidates for spinal fusion surgery.
• Wheel chair modification
• Physical therapy to improve movement

Surgical:

• Rods

If your child is diagnosed with a severe case of curving, your doctor will suggest insertion of growing rods. These are metal rods inserted in the spine to control the curve until your child is ready for spinal fusion surgery. The rods can be made longer so that it does not interfere with the growth of child’s spine.

• Spinal fusion surgery

One of the common treatments performed in children with scoliosis, this surgical procedure aims to stabilize the curve, stop its progression, balance the spine and pelvis region, regain the ability to sit upright and also helps to improve lung function. Spinal fusion is a procedure that involves joining or fusing two or more vertebra together with the help of bone grafts and internal fixators to form one single bone. This surgery is performed either laparoscopically or through one large incision. Bone grafts are taken from your child’s hip or from a bone bank.

Spinal Fusion Surgical Steps:

• A laminectomy is performed. This when the bone that pinches the nerve is removed. This helps to relieve the pressure on the spinal nerves.
• Bone grafts are placed alongside the vertebrae and internal fixators, such as screws, are placed on each side of the vertebrae.
• Rods are attached to connect the screws which ultimately help to stabilize the spine.

Some of the complications observed after the surgery include respiratory problems, wound infections, problems in nutrition and feeding, hip problems and decreases in intestinal function. These complications are common and can be treated accordingly.