July 20, 2015
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Neuromuscular scoliosis more complex, difficult to treat than idiopathic scoliosis

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Findings from a recently published review article demonstrated neuromuscular scoliosis in pediatric patients can lead to more complications and is generally more difficult to treat than idiopathic scoliosis.

According to researchers, although scoliosis is among one of the biggest concerns of certain patients’ parents, it is usually only one of the many problems patience with neuromuscular disease face. Others include nutritional depletion, especially among patients with severe disability, and impaired respiratory function.

Overall, patients with neuromuscular scoliosis (NMS) often have more postoperative complications than patients with idiopathic scoliosis (IS). Pulmonary complications were the most prominent in a meta-analysis of 15,218 patients with NMS, occurring in 22.71% of the patients. Implant-related complications were the next most common, occurring in 12.51% of the patients studied.

The researchers noted a posterior segmental instrumentation approach with hooks, pedicle screws or sublaminar wires has revolutionized surgery as a treatment for NMS. Traditionally, surgery for NMS has been conducted with a combined anterior and posterior approach. Bracing remains the only nonsurgical management for patients with NMS, according to the researchers.

Despite high complication rates, the researchers stated that patients report high satisfaction and high quality of life after treatment for NMS, regardless of the degree of correction.

The researchers concluded that common sense, the needs of the patients, medical morbidities and potential complications should guide the first line of treatment of NMS. – by Robert Linnehan

Disclosures: The researchers report no relevant financial disclosures.