Neuromuscular scoliosis (NS) is one of three commonly distinguished forms of scoliosis.
It is caused by abnormal formation of the spinal bones and spinal nerves, as well as their connection to spinal muscles, causing deformity of the spine.
There are varying levels of this type of scoliosis and unfortunately, the curve progression, or abnormal formation of the spine is usually much more pronounced than in idiopathic forms of scoliosis.
This form of scoliosis affects many thousands of people since it has numerous causes.
There are many causes of neuromuscular scoliosis, including:
- Traumatic paralysis due to injury (spinal cord injuries due to traumatic birth, car accident, abuse, etc.)
- Muscular Dystrophy – A set of diseases that affect the musculature of the body and inhibit correct ambulation.
- Friedrich Ataxia – A genetic disease that causes damage to the nervous system, and thus the spinal nerves and their proper functioning.
- Cerebral Palsy – Another group of diseases that cause non-progressive motor inhibition.
- Spinal atrophy diseases.
- Thoracic Myelodysplasia.
The severity of neuromuscular scoliosis depends upon the involvement of the muscles and nerves in the spinal region. The more involved the muscles, usually, the more acute the spinal curve. Often, the curve can be so extreme that the spine is twisted and arched to over 45 degrees or more and cause it to be impossible for sufferers to walk or even sit up without help. NS is actually classified into two categories: Neuropathic (involving the nerves) and Myopathic (involving the muscles). At its root, the inability of the spine to support the overall structure is the main problem. Other ailments and symptoms can include:
- Skin breakdown due to insensate skin.
- Hip and knee contractures.
- Mental retardation.
- Vision loss.
- Hearing loss.
- Pulmonary issues.
Neuromuscular scoliosis can be helped with surgery, since bracing does not usually correct spinal abnormalities, as it can in some cases of congenital scoliosis, although it is sometimes tried as a first response to symptoms. A wheelchair or supportive seat may also be utilized to support the spine and torso. Orthosis equipment, like soft bracing may be used to help support the thoracic and lumbar spine. When supports are used, they are usually employed prior to puberty. The fast growth spurt that usually accompanies the transition from child to adult results in the inefficacy of said equipment. It simply cannot keep up with the progression of the spinal curve or abnormality with such fast growth of the bones, muscles and nerves.
Surgery is used to halt or slow progression of neuromuscular scoliosis, and aids in helping patients to sit or even stand without help, increases ambulatory functions in patients overall, and decreases pain significantly. X-rays and MRIs are usually used to plan surgery and diagnose the severity of the disease. As with other forms of scoliosis, the earlier the detection of the abnormal progression of spinal growth, the easier it is to treat the anomalies that develop.