← Neuromuscular Scoliosis: A Guide for Families
A neuromuscular curve comes from an underlying condition, not from anything your family did. Large curves keep growing and cause problems with sitting, comfort and care. This page explains what that means for your child and for you.
What is neuromuscular scoliosis?
Scoliosis is an abnormal curve of the spine. The spine may also rotate (twist), which makes the ribs or trunk more prominent. In neuromuscular scoliosis, the curve is caused by conditions with muscle weakness or spasticity, such as:
- Cerebral palsy: brain and nerve problems caused by brain injury or abnormal development of the brain
- Muscular dystrophy: muscle weakness and loss of muscle tissue
- Spinal cord injury: damage to the nerves inside the spine
- Spina bifida: the spine does not close all the way around the spinal cord during pregnancy
- Spinal muscular atrophy: a genetic condition with significant muscle weakness
What causes it?
- Spine and upper body muscles that are too weak or too tight place abnormal forces on the spine, pulling it more one way than the other. A curve results
- Hip and pelvis muscles that are too weak or too strong shift the trunk, so the head is no longer centred over the pelvis
- The abnormal muscle tone comes from the underlying condition
How do we know how severe the curve is?
- We measure the curve on X-ray
- It is measured by how many degrees the spine bones are tilted (the Cobb angle)
- The bigger the angle, the worse the curve, and the more likely problems are
Why is it a problem?
- Small curves (under 40 to 50 degrees) do not usually cause problems. We schedule regular follow-up to measure any increase
- Once a curve reaches 40 to 50 degrees, it can be expected to grow by at least a degree a year, and sometimes 10 degrees or more. Bigger curves cause more problems
How fast can it grow? In one child, over nine months of X-rays, the curve measured 45 degrees at the start, 65 degrees three months later, 75 degrees three months after that, and 90 degrees nine months from the first X-ray.
What can a big curve (over 40 to 50 degrees) cause for your child?
- Wheelchair transfers get harder
- Hip and pelvic deformity can increase, which can cost your child sitting balance or the ability to sit independently. Sometimes sitting problems come from other causes, such as hip dislocation or tight hip muscles, and we will work out the cause in your child
- More frequent skin sores, from pressure points created by the tilting of the spine and hips
- Frequent or constant pain
- Breathing problems, which increase with severe curves (over 80 degrees). Weak breathing muscles, or not being able to clear secretions from the lungs, can also cause them
What can a big curve cause for you as a parent or carer?
- Dressing is harder
- Positioning is harder
- Feeding is harder
- Wheelchair transfers are harder