Neuromuscular Scoliosis: Current Concepts on Surgical Care

Tiziana Greggi, Mario Di Silvestre, Stefano Giacomini, Francesco Vommaro, Kostantinos Martikos, Aristide Morigi, Maria Renata Bacchin, Francesca Pastorelli

Research output: Contribution to journalArticlepeer-review


Scoliosis is a common deformity in many types of
neuromuscular disease. The orthopaedic surgeon is often the first
physician who is required to diagnose and treat a young patient
with spinal deformity and neuromuscular disorders. These
diseases make to lose the ability to ambulate and determine
the progression of scoliosis with collapse of the column. Severe
spinal curvature can cause difficulty also in sitting. Conservative
and surgical treatment of neuromuscular scoliosis differs from
idiopathic scoliosis, being more complex and with a higher
complications rate [1]. Non-surgical treatment rarely fully
controls progressive deformity of the spine. Corrective surgery
requires multidisciplinary management and perioperative
difficult screening. Pelvic obliquity is commonly associated with
neuromuscular scoliosis, making sitting difficult: correction
needs to be considered during surgical planning.
The goal of surgical correction is to obtain and maintain a
well-balanced spine above a well-positioned pelvis. Preoperative
multidisciplinary study enables potential problems or
complications. Respiratory function investigation will guide
possible non-invasive perioperative ventilation. Nutritional and
psychosocial assessment should also be incorporated in this
preparation, as should overall postoperative care. Implementing
this overall strategic planning can achieve a good surgical and
functional result in the vast majority of cases. Pedicle screws
have shown to be a safe and effective method of spinal fixation,
offering superior multiplanar correction compared with hooks
or sub laminar wires in selected situations [2]. We started over
a decade, using only pedicle screw instrumentation for the
surgical treatment of scoliosis. The positive results have led us
to extend this technique with some certainty to the treatment
of the most severe deformities such as neuromuscular scoliosis.
Original languageEnglish
Pages (from-to)1-3
Number of pages3
JournalOrthopedics and Rheumatology
Issue number5
Publication statusPublished - Oct 2017

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