Adult Neuromuscular Scoliosis
Neuromuscular disorders affecting the spine can result from neruopathic or myopathic conditions. The spinal deformities are less prevalent than in idiopathic scoliosis. Most common disorders are cerebral palsy, spinal muscle atrophy, Duchene muscular dystrophy, poliomyelitis, and traumatic causes. Adult with spina bifida can also develop varying forms of spinal deformity depending on the level of involvement. It is not uncommon for an adult to present with a deformity which has been present during early years of life and persist or progress during adulthood. Neurological disorders that present later in life, such as Parkinson's Disease and Multiple Sclerosis can also lead to spinal deformities.
Types of Deformities
The deformity may affect the cervical, cervico-thoracic, thoracic, thoracolumbar or lumbar spine and or combination thereof depending on underlying neuromuscular disease and level of neurologic defect. It may be predominantly scoliosis, kyphosis, lordosis or in combination (figure 1A).Presentation
Adult with persisting deformity may present with pain, progressive deformity functional impairment such as loss of sitting balance especially in quadriplegics and paraplegics. In some instances pulmonary or breathing problems may result from chest wall muscle paralysis such as in poliomyelitis (figure 2A and 2B).
 Figure 1A : 40 yo male, CP, spastic quadriplegic, progressive loss of sitting balance |
 Figure 2A: 19 yo F, myelo kyphoscoliosis |
 Figure 2B: Sitting Support Orthosis (SSO) |