SPINE DEFORMITIES
NEUROMUSCULAR SCOLIOSIS
Causes, Symptoms, and Treatment Options for Neuromuscular Scoliosis
Neuromuscular scoliosis is a type of spinal curvature that develops due to an underlying neurological or muscular condition. Unlike Idiopathic scoliosis or Congenital scoliosis, which occurs with no known cause or due to birth defects, neuromuscular scoliosis results from disorders that affect the nerves or muscles. Conditions such as muscular dystrophy, cerebral palsy, spina bifida, or spinal cord injuries can weaken the muscles that support the spine, causing it to curve abnormally. This form of scoliosis tends to progress more quickly than other types, often leading to more severe spinal deformities.
Causes
Neuromuscular scoliosis is directly related to conditions that impact the nervous system or muscular function. The spine relies on balanced muscle strength to stay correctly aligned, but when muscles become weak or uncoordinated due to neuromuscular diseases, the spine can begin to curve abnormally. Common conditions that can lead to neuromuscular scoliosis include:
- Muscular dystrophy: A group of genetic diseases that cause progressive muscle weakness and degeneration.
- Cerebral palsy: A neurological disorder that affects movement, muscle tone, and posture, often leading to uneven muscle strength.
- Spina bifida: A birth defect where the spine and spinal cord do not develop properly, leading to weakness and sometimes paralysis.
- Spinal cord injuries: Injuries that damage the spinal cord can cause paralysis or significant muscle weakness, contributing to the development of scoliosis.
Symptoms
The symptoms can vary depending on the severity of the curve and the underlying condition. In most cases, the curvature progresses rapidly, making it more severe than other forms of scoliosis. Common symptoms include:
- Visible curvature of the spine: A noticeable side-to-side curve in the spine that worsens over time.
- Uneven shoulders or hips: As the spine curves, one shoulder or hip appears higher than the other.
- Difficulty sitting or standing: In more severe cases, children may struggle to maintain an upright position due to muscle weakness.
- Breathing difficulties: A significant spinal curve can compress the chest cavity, leading to respiratory issues.
Treatment Options
Because scoliosis tends to progress quickly, early detection and treatment are crucial. The treatment approach depends on the severity of the curvature and the patient’s overall health. Common treatment options include:
- Bracing: In some cases, bracing may be used to slow the progression of the curve, though it may not entirely stop it in neuromuscular cases.
- Surgery: Surgical intervention, such as spinal fusion, may be recommended in more severe cases to correct the curvature and stabilise the spine.
- Physical therapy: Strengthening the muscles around the spine can help improve posture and support the back, though it may not stop curve progression.
Careful Management
Neuromuscular scoliosis is a complex condition caused by underlying neurological or muscular diseases. It requires careful management and treatment to prevent rapid progression and complications. Early detection is vital, and families should work closely with healthcare professionals to create a treatment plan tailored to the patient’s needs, ensuring better quality of life and minimising long-term complications.
Rowan Berkowitz is one of South Africa’s leading experts in the field of Spine and Chest Deformities; click here to book an appointment.