Neuromuscular Spine Deformities

Abstract

Neuromuscular scoliosis in patients under the age of 10 years is characterized by a disease-specific high progression rate due to muscular imbalance such as the primum movens, ongoing growth, and osteopenia. Those mostly non-ambulating patients typically suffer from pelvic obliquity, loss of sitting balance, rib impingement on the iliac crest, delicate skin conditions, and concomitant medical problems such as pulmonary function deficits, recurrent urinary infections, malnutrition, and skin ulcerations. The resulting therapeutic challenge is that of an increasing spine deformity in a sick patient. The type and timing of intervention should be based on a sound knowledge of the specific natural history and multiple disease-specific factors but should also take the individual needs of the patient and his psychosocial environment into thorough consideration to avoid complications and disasters in this high-risk population.