Scoliosis is a condition in which the spine curves abnormally. The condition is classified as neuromuscular scoliosis when it is caused by a neuromuscular disease. With this type of scoliosis, the spine curves laterally, or to the side, in either a C or S-shape. Patients may develop a mild, or a progressively more severe, curvature.
There are many neuromuscular diseases that can cause this condition. Polio, cerebral palsy, and muscular dystrophy may result in curvature of the spine. It can also be caused by spinal muscular atrophy and spina bifida. These neuromuscular conditions can result in muscle weakness, inadequate muscle control, and paralysis that can contribute to a spinal curvature.
Moderate to severe cases of neuromuscular scoliosis can result in additional complications. Patients may have mobility problems and experience pain while sitting. They may be confined to a specially-modified wheelchair. Those suffering from this condition can also have difficulty breathing, as well as lung and heart damage. These can occur if the spine causes the rib cage to press against the heart and lungs.
Some possible symptoms of neuromuscular scoliosis include back pain and fatigue after prolonged standing or sitting. The pelvis may also appear to be tilted. Uneven shoulders may also be observed. One shoulder may appear to be higher than the other. The patient's hips may also appear uneven.
An initial screening for scoliosis is often a physical exam that may indicate a possible curvature of the spine. X-rays are usually needed to confirm this. A doctor may also order a scoliometer screening, which is a method used to measure the degree of curvature.
Neuromuscular scoliosis treatment generally depends on the severity of the curvature, whether there are any complications, and the age of the patient. Children with scoliosis may develop worsening curves, as their bones are still growing. The severity of these curves also tends to be worse in female patients.
Mild cases of spine curvature may not need to be treated. The patient may need to have regular exams to monitor the progression of the condition. Often, a doctor may recommend the use of a brace in cases of mild to moderate scoliosis. This can help to slow the progression of the curve, but it is typically less effective in cases of neuromuscular scoliosis, as opposed to other types of the disorder.
The decision to have surgery to correct spinal curvature is typically based on the degree of curvature, the progression of curvature, and the extent to which the condition interferes with the patient's daily life. Surgery cannot fully correct the condition, however, it can alleviate it. Procedures for scoliosis usually involve fusing certain bones together. Occasionally, the patient may need to undergo a second spinal fusion surgery.