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Spinal Decompensation in Neuromuscular Disease

Kouwenhoven, Jan-Willem M., MD; Van Ommeren, Peter M., MD; Pruijs, Hans E. J., MD, PhD; Castelein, René M., MD, PhD

doi: 10.1097/01.brs.0000208131.42824.c3
Deformity
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Study Design. In this retrospective radiography study, we analyzed curve shape and direction in scoliosis secondary to neuromuscular disease.

Objective. To determine if in different types of neuromuscular scoliosis a predominant curve pattern can be found and if similarities with idiopathic scoliosis exist.

Summary of Background Data. To the authors' knowledge, systematic analysis of curve patterns in patients with neuromuscular scoliosis has not been performed in a group of this size and composition.

Methods. Spinal full-length radiographs of 198 patients with neuromuscular scoliosis were analyzed for curve shape and direction. Patients were divided into 4 groups consisting of Duchenne muscular dystrophy, cerebral palsy, spinal muscular atrophy, and spina bifida.

Results. The results of this study show a predominance of right-sided thoracic and thoracolumbar curves, and left-sided lumbar curves, which differed significantly from an equal right-left distribution. Apical levels were respectively at T8, T12/L1 disc, and L2.

Conclusion. In neuromuscular scoliosis, curve patterns and apical levels are similar to what is seen in the most prevalent types of adolescent idiopathic scoliosis.

This retrospective radiography study in 198 patients with scoliosis secondary to neuromuscular disease showed a predominance of right-sided thoracic and thoracolumbar curves, and left-sided lumbar curves with apical levels similar to what is seen in the most prevalent types of adolescent idiopathic scoliosis.

From the Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands.

Acknowledgment date: March 29, 2005. First revision date: June 27, 2005. Acceptance date: August 9, 2005.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Other funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

This work was supported by Anna Fonds and Biomet.

Address correspondence and reprint requests to René M. Castelein, MD, PhD, Department of Orthopedics, G05.228, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3508 GA Utrecht, The Netherlands; E-mail: r.m.castelein@umcutrecht.nl

© 2006 Lippincott Williams & Wilkins, Inc.