Spine Surgeon in Broward County – Neuromuscular Scoliosis (NMS) – What it is, causes, treatment options



Neuromuscular Scoliosis is a type of scoliosis that can can affect children and adolescents. According to Scoliosis Research Society (SRS) it is “an irregular spinal curvature caused by disorders of the brain, spinal cord, and muscular system. Nerves and muscles are unable to maintain appropriate balance / alignment of the spine and trunk. Neuromuscular curves are often associated with pelvic obliquity, a condition in which the child’s pelvis is unevenly tilted with one side higher than the other”1. In other words, it is a condition that causes the spine to curve sideways. It is a result of the muscles around the spine being unable to support it. NMS can cause the patient to have trouble sitting, walking, as well as experience pulmonary difficulties.

Main types of Neuromuscular Scoliosis

Idiopathic scoliosis – the most common type of scoliosis and often shows up in children when they reach puberty. The exact cause of the condition is difficult to establish (‘idiopathic’)
Congenital scoliosis – it develops before birth. Babies with congenital scoliosis may have spinal bones that are not fully formed or are fused together2.

What causes it?

NMS is typically caused by another condition that affects either the body’s neurological system or muscular system, or sometimes both. It commonly develops (or becomes visible) when the patient goes through a rapid growth spurt. The table below shows how other neuromuscular condition increase the risk of developing NMS:

Neuromuscular ConditionIncidence of Scoliosis
Cerebral palsy (2-limbs involved)              


Myelodysplasia (lower lumbar)              


Spinal muscle atrophy              


Friedreich ataxia              


Cerebral palsy (4-limbs involved)              


Duchenne muscular dystrophy              


Myelodysplasia (thoracic level)              


Traumatic paralysis (<10 years)

25%

60%

67%

80%

80%

90%

100%

100%

Source: Scoliosis Research Society

The symptoms include an overall change posture, a tilted pelvis, uneven shoulder blades, waistline, and hips. It can significantly affects the child’s mobility, making the everyday activities such as dressing up or taking a shower a challenge. There are many other conditions which can cause back pain – for example spinal stenosis, disc herniation, and spondylolisthesis just to name a few – so it is important to get an expert opinion. Our orthopedic surgeon in Fort Lauderdale and Delray Beach will be able to diagnose the cause of your pain.

Treatment

The treatment of NMS has to be approached interchangeably by medical doctors in various specialties –  orthopaedics, pediatrics, pulmonology, neurology, urology, nutrition, and gastroenterology. There are different types of treatment options available depending on the patient’s condition. Nonsurgical options include may physical therapy (a set of exercises aimed to improve the patient’s ability to move), bracing (to provide upper body stability and ability to use hands), and wheelchair modification for non-ambulators (to improve balance and function).

There are however indicators for surgery treatment. The surgery will allow to stop the symptoms from progressing and well as reduce the repositioning and pain. Surgical options may include surgical stabilization, growing rods, or spinal fusion. The decision about whether to undergo surgery is not an easy one due to the possibility of complications, therefore, make sure you discuss all of your options with your Spine Surgeon in Broward County.

Spine Surgeon in Broward County – Dr. Matthew Hepler    

Dr. Hepler is an adult and pediatric Orthopedic spine surgeon in Broward County, Fort Lauderdale and Delray Beach. He treats all conditions of the cervical, thoracic and lumbar spine, including spinal stenosis, spondylolisthesis, and many other conditions. In addition to performing back surgery in Fort Lauderdale and Delray Beach, he also provides non-operative treatment options, such as pain medications, steroid injections, and physical therapy and operative treatment including both minimally invasive techniques and complex reconstruction. Here you will find more information about our Spine Surgeon in Broward County.