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Review
. 2014 Apr 18;5(2):124-33.
doi: 10.5312/wjo.v5.i2.124.

Surgical advances in the treatment of neuromuscular scoliosis

Federico Canavese  1 , Marie Rousset  1 , Benoit Le Gledic  1 , Antoine Samba  1 , Alain Dimeglio  1
Affiliations
Review

Surgical advances in the treatment of neuromuscular scoliosis

Federico Canavese et al. World J Orthop. .

Abstract

Neuromuscular disorders are a group of diseases affecting the neuro-musculo-skeletal system. Children with neuromuscular disorders frequently develop progressive spinal deformities with cardio-respiratory compromise in the most severe cases. The incidence of neuromuscular scoliosis is variable, inversely correlated with ambulatory abilities and with a reported risk ranging from 80% to 100% in non-ambulatory patients. As surgical and peri-operative techniques have improved, more severely affected children with complex neuromuscular deformities and considerable co-morbidities are now believed to be candidates for extensive surgery for spinal deformity. This article aimed to provide a comprehensive review of how neuromuscular spinal deformities can affect normal spine balance and how these deformities can be treated with segmental instrumentation and sub-laminar devices. Older concepts have been integrated with newer scientific data to provide the reader with a basis for better understanding of how treatment of neuromuscular scoliosis has evolved over the past few decades. Recent advances, as well as challenges that remain to be overcome, in the surgical treatment of neuromuscular curves with sub-laminar devices and in the management of post-operative infections are outlined.

Keywords: Luque rod; Neuromuscular scoliosis; Sub-laminar bands; Surgery; Unit rod.

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Figures

Figure 1
Figure 1
A 16-year-old girls with cerebral palsy (GMFCS IV). This non-ambulatory patient was operated on with band-only instrumentation. A: Pre-operative supine anteroposterior X-rays; B: Pre-operative supine left bending X-rays (reducibility of 13%). C: Post-operative supine anteroposterior X-rays; D: Post-operative supine lateral X-rays.
Figure 2
Figure 2
A 15-year-old boy with a genetic syndrome. This ambulatory patient was operated on with a hybrid construct. A: Pre-operative standing anteroposterior x-rays; B: Pre-operative supine left bending X-rays (reducibility of 24%); C: Post-operative seated anteroposterior X-rays; D: Pre-operative standing lateral X-rays; E: Post-operative seated lateral X-rays.
See this image and copyright information in PMC

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