Early onset neuromuscular scoliosis

In comparison to other forms of scoliosis, neuromuscular scoliosis often has an early onset with rapid progression during growth, which may continue to progress following skeletal maturity. It is more likely to present with severe spinal deformities that frequently involve the sacrum, and may have associated pelvic obliquity. Neuropathic disorders, including cerebral palsy (CP), spinal muscular atrophy (SMA), myelomeningocele, and Rett syndrome, are more commonly associated with early onset. Several goals of care, including maintenance of function and delay of surgical intervention, can be assisted by non-operative interventions. Bracing can be used to control the progression of curves during growth periods and delay the need for surgery until it can be performed safely. Similar to conservative management, the goals of surgical intervention are to control curve progression and provide stability in the coronal and sagittal plane and may be considered in patients with rigid curves greater than ~60-75°. In comparison to idiopathic and congenital scoliosis patients, patients with neuromuscular scoliosis have high rates of complications associated with both treatment and their underlying disease state.