Abstract
Neuromuscular scoliosis encompasses varying pathologies that influence the muscular and neural system in patients, leading to the development of scoliosis. The most common diagnosis encountered with neuromuscular scoliosis is cerebral palsy. Deformity correction in these patients is associated with a high risk of complications, often because of the curve magnitude and underlying comorbidities. However, a comprehensive multidisciplinary approach preoperatively can help optimize these patients and minimize adverse events. This chapter will discuss the general principles in neuromuscular scoliosis and address more specific issues related to patients with cerebral palsy, myelodysplasia, and neurodegenerative disorders, including basic principles around diagnosis, classification, and evaluation of patients. Then we will delve into natural history and nonoperative management, followed by preoperative optimization and consensus guidelines. Finally, the chapter will discuss surgical indications and goals, as well as complication avoidance and management strategies. Subsections will address considerations specific to cerebral palsy–related neuromuscular scoliosis and myelodysplasia in the child, as well as neuromuscular deformity in the adult.
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