Functional Outcome of the Surgical Correction of Neuromuscular Scoliosis

Abstract

Study Design : A retrospective study of functional outcome after surgical correction of neuromuscular scoliosis. Objectives : To assess functional outcomes and their significances after the surgical correction of neuromuscular scoliosis. Summary of Literature Review : The surgical correction of neuromuscular scoliosis has been used to stabilize the trunk for balanced sitting, to improve cardiopulmonary function, and the function of the upper extremities. Many authors have reported favorable surgical results, but few studies have been undertaken on functional assessment after surgery. Materials and Methods : Eighteen adult patients with neuromuscular scoliosis underwent surgical correction. Functional assessments were performed in terms of impairments, disabilities, and handicaps. The impairments included sitting ability, coronal Cobb’s angle, pain after surgery, and cosmesis after surgery. The disabilities included dressing, feeding, toilet/bathing, locomotion, and the use of both hands, and the handicaps included the effort and time to care for patients. Each parameter was checked preoperatively, 6 months after surgery, and at the last follow-up. Results : In terms of impairments, sitting ability, coronal Cobb’s angle, pain, and cosmesis were improved by surgery. In terms of disabilities, dressing, toilet/bathing, and locomotion were not improved after surgical correction. However, the feeding and use of both hands were significantly improved. And, in terms of handicaps, both the effort and the time required for care were reduced post-surgically. Conclusions : We conclude that impairments, handicaps, and the functions of the upper extremities were improved after surgical intervention to stabilize the trunk and spine in cases of neuromuscular scoliosis, but that overall disabilities were unaffected. This latter apparent shortcoming is attributed to the inability of surgery to treat previous systemic disease affecting physical disabilities of lower extremities. However, surgical correction of neuromuscular scoliosis was found to be clinically significant in terms of improving the functions of the trunk and of the upper extremities.