Scoliosis Research Society (SRS)
An International Organization Dedicated to the Education, Research and Treatment of Spinal Deformity
Our Mission is to Foster Optimal Care for All Patients with Spinal Deformities
Physical Exam Findings
Depending on the etiology, patients may or may not be able to walk. Certain disorders allow children to walk when they are young, but become wheelchair dependent during adolescence. In non-ambulators, trunk imbalance is common as the curves increase in size. Larger curves often force children to use their han
ds to improve sitting stability. Pelvic obliquity (tilt) is also common leading to sitting intolerance, and increased likelihood of skin breakdown (decubitus ulcers). Larger thoracic curves (80+o) or hyperlordotic curves (backward bend) may contribute to pulmonary problems.
Because of the many causes of neuromuscular scoliosis, the incidence is variable (Table 1). The likelihood and severity of the curves tends to increase with the degree of neuromuscular involvement.
|Diagnosis||Incidence of Scoliosis|
|Cerebral palsy (2-limbs involved)
Myelodysplasia (lower lumbar)
Spinal muscle atrophy
Cerebral palsy (4-limbs involved)
Duchenne muscular dystrophy
Myelodysplasia (thoracic level)
Traumatic paralysis (<10 years)
Unlike idiopathic scoliosis, bracing is typically not effective for treating neuromuscular scoliosis. Smaller curves can be braced or treated with wheelchair modifications (in non-ambulators) in order to improve function.
It is important to have a multidisciplinary team evaluate and treat the patients as necessary. Pulmonary, neurologic, genitourinary, orthopaedic, nutritional and gastroenterologic issues are common and must be coordinated between health care providers.