Our Summary

This research paper discusses neuromuscular scoliosis, a condition that affects the spine and can lead to reduced quality of life, loss of ability to walk, stand, or sit, and can even affect the heart and lungs. If not properly managed, this condition can result in increased risk of death. As such, it’s crucial to have a team of specialists, including physiotherapists, internal medicine doctors, pediatricians, and orthopedic surgeons, to provide comprehensive treatment.

The paper highlights that the use of orthosis (braces or other devices to correct deformities) to treat neuromuscular scoliosis is a topic of debate, but physiotherapy is an established and necessary part of treatment to prevent stiffness and to maintain the remaining function of the muscles and nerves.

The research emphasizes that surgery is often required to treat scoliosis. The most effective type of surgery involves correcting and fusing the entire deformed area of the spine, which can significantly improve quality of life and stop the scoliosis from getting worse. This surgery is usually carried out before growth ends.

Delaying surgery does not result in a height increase and only leads to the condition worsening, so it’s not a reasonable option. For early onset neuromuscular scoliosis, implants that guide growth are used to ensure proper development. However, due to the high complication rates of these implants, further research is needed to improve their effectiveness and safety.

FAQs

  1. What is neuromuscular scoliosis and how does it impact quality of life?
  2. What is the role of surgery in treating neuromuscular scoliosis and when is it typically carried out?
  3. What are the complications associated with the use of implants for early onset neuromuscular scoliosis and what research is being done to improve their safety and effectiveness?

Doctor’s Tip

A doctor might tell a patient undergoing scoliosis surgery to follow all post-operative care instructions carefully, including physical therapy exercises, wearing any prescribed braces or supports, and attending follow-up appointments. It’s important to take pain medication as prescribed, avoid heavy lifting or strenuous activities, and gradually increase activity levels as directed by the medical team. Proper nutrition and hydration are also important for healing and recovery. Be sure to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Overall, patients with neuromuscular scoliosis who have severe curvature of the spine, significant pain, difficulty breathing, or impaired mobility are typically recommended for surgery. It is essential for these patients to be evaluated by a team of specialists to determine the best course of treatment for their individual case. Surgery can greatly improve the quality of life for these patients and prevent further complications associated with neuromuscular scoliosis.

Timeline

Before scoliosis surgery:

  • Patient may experience pain, difficulty breathing, limited mobility, and spinal deformity
  • Patient undergoes physical examination, imaging tests (X-rays, MRI), and possibly pulmonary function tests
  • Patient may receive conservative treatments such as physiotherapy, orthosis, and pain management

After scoliosis surgery:

  • Patient undergoes pre-operative preparation, including blood tests, anesthesia consultation, and education on post-operative care
  • Surgery is performed to correct and fuse the spine
  • Patient may stay in the hospital for a few days to a week for recovery
  • Patient undergoes physical therapy and rehabilitation to regain strength and mobility
  • Patient may need to wear a brace or have restrictions on physical activities for a period of time
  • Patient attends follow-up appointments to monitor progress and address any complications
  • Patient may require ongoing care and monitoring to prevent recurrence of scoliosis or complications from surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scoliosis surgery may include:

  1. What are the potential risks and complications associated with scoliosis surgery?
  2. How long is the recovery period after surgery and what can I expect during that time?
  3. Will I need to undergo physical therapy or rehabilitation after surgery?
  4. What are the long-term effects of scoliosis surgery and how will it impact my daily life?
  5. Are there any alternative treatments or non-surgical options for managing scoliosis?
  6. How will the surgery affect my ability to participate in physical activities or sports?
  7. What is the success rate of scoliosis surgery and what are the chances of the condition returning in the future?
  8. Will I need to have additional surgeries or treatments in the future to maintain the results of the initial surgery?
  9. Are there any restrictions or lifestyle changes I will need to make after undergoing scoliosis surgery?
  10. Can you provide me with information about the surgical procedure, including what to expect before, during, and after surgery?

Reference

Authors: Putzier M, Groß C, Zahn RK, Pumberger M, Strube P. Journal: Orthopade. 2016 Jun;45(6):500-8. doi: 10.1007/s00132-016-3272-7. PMID: 27197823