Neuromuscular Scoliosis | Treatment

What are the treatment options for neuromuscular scoliosis?

Non-surgical treatments

Most neuromuscular conditions are diagnosed early in a child's life, and neuromuscular scoliosis may also present early. When scoliosis appears, non-surgical treatments such as bracing, wheelchair modification, physical therapy and environmental adaptation will be used to help your child adapt to everyday environments, and to improve mobility.

Spinal fusion surgery

While most non-ambulatory pre-adolescent children are usually treated with bracing to control (not correct) spinal curves while they grow, stabilization by spinal fusion surgery is the most common treatment for neuromuscular scoliosis by the time a child reaches adolescence. But treatment will vary according to the type and severity of a child's neuromuscular condition.

The goal of a spinal fusion is to:

  • stabilize the curve and stop its progression
  • balance the spine and pelvis (usually in non-ambulatory patients)
  • regain the ability to sit upright (in children who have lost this ability)
  • improve/preserve lung function

Spinal fusion for neuromuscular scoliosis usually has these characteristics:

  • It's needed by the time a child reaches adolescence (usually sooner than with idiopathic scoliosis).
  • The fused portion of the spine is longer than with idiopathic scoliosis.
  • Surgeons use metal rods, hooks, screws and wires during surgery to correct the spinal curve and secure the spine in position while the fusion heals and becomes solid.
  • Combined anterior/posterior surgery is a common approach because some posterior elements may be missing from spine (as in spina bifida), and this approach helps achieve a spine with pelvis in balance.

What is the long-term outlook for children with neuromuscular scoliosis?

The outlook depends on the nature, severity and effects of your child’s neuromuscular disease, and less on the scoliosis. With successful surgery and attentive post-operative care, your child can:

  • return to the functional level attained before surgery
  • have the spine solidly fused and in balance, reducing the deformity
  • have the potential for improved lung function and decreased susceptibility to pneumonia
  • find it easier to sit up