Neuromuscular Scoliosis and Its Types

Neuromuscular scoliosis develops  at a younger age than idiopathic curves and a larger percentage of neuromuscular curves are progressive. Usually neuromuscular curves are long, C-shaped curves  and associated  pelvic obliquity is common.

The basic treatment methods are similar – observation, orthotic treatment, and surgery.

The goal of treatment is to maintain a spine balanced in the coronal and sagittal planes over a level pelvis.

These patients generally are less compliant with orthotic management  and surgery is associated  complications like increased bleeding, less satisfactory bone stock, longer fusions, and the necessity for fusion to the pelvis.

A classification of  neuromuscular scoliosis is given below [Scoliosis Research Society]-

Neuropathic

Upper motor neuron

• Cerebral palsy
• Spinocerebellar degeneration
• Friedreich ataxia
• Charcot-Marie-Tooth Disease
• Roussy-Levy Syndrome
• Syringomyelia
• Spinal cord tumor
• Spinal cord trauma

Lower motor neuron

• Poliomyelitis
• Other viral myelitides
• Traumatic
• Spinal muscle atrophy
• Werdnig-Hoffmann
• Kugelberg-Welander
• Dysautonomia (Riley-Day syndrome)

Myopathic

Arthrogryposis

Muscular dystrophy

• Duchenne
• Limb-girdle
• Facioscapulohumeral

Fiber-type disproportion

Congenital hypotonia

Myotonia dystrophica