Surgical advances in the treatment of neuromuscular scoliosis

Table 2 Surgical risk

Surgical risk	Walking abilities	Weight	Cardiac Function	Respiratory function (VC)	Sleep	Comorbidities
Average	Ambulatory	> 40 kg	Normal	Normal	Normal	No
Increased	Ambulates with aid	20-40 kg	Reduced	Reduced, but > 50%	Hypersomnia
High	Non ambulatory	< 20 kg or obese	Significantly impaired	< 50%	Nocturnal hypercapnic Hypoventilation, Obstructive sleep apnea	Yes

In addition to neuromuscular pathology, factors such as walking abilities, nutritional status, cardiopulmonary function and the presence of other comorbidities, must be considered prior to surgery to minimize surgical risk. Morbidity is higher in non-ambulatory patients, with reduced weight and impaired cardiopulmonary function.