Neuromuscular scoliosis is an abnormal curvature of the spine which is associated with the disorders that affect the nerves and muscles. Some of the medical conditions that result in curving of the spine include cerebral palsy, muscular dystrophy, spinal cord injury, spinal bifida, and polio.
Neuromuscular scoliosis is caused by muscle weakness, poor muscle control or paralysis in children. This condition worsens once the growth spurt occurs and makes it difficult for the child to sit comfortably. Curving also reduces the lung space leading to increased risk of pneumonia, breathing problems, and obstruction of lung function.
Some of the signs that may be noticed in your child include uneven height of shoulders and hip, uneven buttocks, misalignment of head compared to rest of the body, and the left and right side of your child’s back appears at a different height when your child bends forward.
Neuromuscular scoliosis is diagnosed by physical examination, child’s medical and family history and few diagnostic tests to confirm the condition such as X-ray, MRI scan, CT scan, and bone scan.
The treatment options include non-surgical and surgical methods. Non-surgical treatment includes braces which provide support to the trunk when the child is seated. Other non-surgical treatment options include wheelchair modification, physical therapy to improve your child’s movement. If your child is unable to walk because of the neuromuscular disease then he/she will be treated with braces to control the curve while they grow and are also considered to be the best candidates for spinal fusion surgery.
If your child is diagnosed with severe case of curving, your doctor will suggest insertion of growing rods. These are metal rods inserted in the spine to control the curve until your child is ready for spinal fusion surgery. The rods can be made longer so that it does not interfere with the growth of child’s spine.
Spinal fusion surgery is one of the common treatments performed in children with scoliosis. This surgical procedure aims to stabilize the curve, stop its progression, balance the spine and pelvis region, regain the ability to sit upright, and also helps to improve lung function. Spinal fusion is a procedure that involves joining or fusing two or more vertebra together with the help of bone grafts and internal fixators to form one single bone. This surgery is performed either laparoscopically or through one large incision. Bone grafts are taken from your child’s hip or from a bone bank.
At first, laminectomy is done where the bone that pinches the nerve is removed. This helps to relieve the pressure on the spinal nerves. Bone grafts are placed along with the vertebrae and internal fixators such as screws are placed on each side of the vertebrae. Rods are attached to connect the screws which help to stabilize the spine.
Some of the complications observed after the surgery include respiratory problem, wound infection, problems in nutrition and feeding, hip problem, and decrease in intestinal function. These complications are common and can be treated accordingly.
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