The Etiological Understanding of Spine Deformities in Patients with Neuromuscular Disorders

Abstract

Purpose: The etiology understanding is the corner stone for proper management of the spine deformities in patients with neuromuscular disorders. Methods: Progressive spine deformities have been encountered in 71 patients. All showed different forms of neuromuscular disorders. We proceeded with applying prompt evaluation criteria which was mainly based on the etiological diagnosis of each type of NMS (clinical phenotype and genotype). Assessing the Functional Independence Measure (FIM), we observed deterioration in some aspects. The Cobb’s angle was assessed in two occasion’s i.e prior to corrective surgeries plus the post-surgery results. Followed by one year postoperative re-assessment. Surgical corrections have been performed via posterior pedicle screw fixation. Results: Surgical correction to re-align the C-shaped thoracolumbar scoliosis. Lumbar hyper lordosis were common in cerebral palsy patients, though decreased thoracic kyphosis or even thoracic lordosis occurs more frequently in Duchenne Muscular atrophy patients. There was noticeable improvement in functional status according to Functional Independence Measure (FIM). Conclusion: Etiology understanding is the paramount element in re-aligning corrective surgeries of the spine in patients with progressive spine deformities. We concluded that rigid hyper lordosis has been and still the key problem encountered in patients with neuromuscular disorders.