Review
Copyright ©2014 Baishideng Publishing Group Co.
World J Orthop. Apr 18, 2014; 5(2): 124-133
Published online Apr 18, 2014. doi: 10.5312/wjo.v5.i2.124
Table 1 Incidence
DiagnosisIncidence of scoliosis
Cerebral palsy25% (GMFCS I and II) to 100% (GMFCS IV and V)
Charcot-Marie-Tooth disease30%
Myelodysplasia60% (lumbar level) to 100% (thoracic level)
Spinal muscular atrophy70%
Friedreich ataxia80%
Duchenne muscular dystrophy90%1
Paralysis from spinal cord injury100%
Table 2 Surgical risk
Surgical riskWalking abilitiesWeightCardiac FunctionRespiratory function (VC)SleepComorbidities
AverageAmbulatory> 40 kgNormalNormalNormalNo
IncreasedAmbulates with aid20-40 kgReducedReduced, but > 50%Hypersomnia
HighNon ambulatory< 20 kg or obeseSignificantly impaired< 50%Nocturnal hypercapnic Hypoventilation, Obstructive sleep apneaYes
Table 3 Decade 1980-1989
Decade-Year of publicationAuthorsPatients (n)Neuromuscular conditionInstrumentationComplications (number of patients)
1980-1989
1982Allen et al[13]10Cerebral palsyL-rod
1986Sponseller et al[14]34Cerebral palsyInterspinous process instrumentation
1988Gersoff et al[16]33Cerebral palsyL-rod5 deep wound infections
Complications rate: 15%
1989Broom et al[18]74VariousL-rod1 death;
3 deep wound infections;
2 pressure sores;
6 sets of broken rods;
1 distal rotation and migration of the rod
Complications rate: 18%
1989Boachie-Adjei et al[17]46VariousL-rod3 cases of pseudarthrosis;
3 deaths
Complications rate: 13%
Table 4 Decade 1990-1999
Decade-Year of publicationAuthorsPatients(n)Neuromuscular conditionInstrumentationComplications(number of patients)Outcome/Conclusions
1990-1999
1991Gau et al[34]68VariousLuque-Galveston instrumentation14 hardware problems;
7 cases of pseudarthrosis;
3 neurologic deficits
Complications rate: 35%
1992Hopf et al[35]44Various
1992Neustadt et al[36]18VariousCDI of the pelvis1 hardware failure;Posterior spinal fusion with CDI of the pelvis is an effective treatment for patients with neuromuscular scoliosis.
1 deep wound infection
Complications rate: 11%
1992Onimus et al[37]32Cerebral palsy3 deaths;Pain disappeared in 2/3 of cases;
10 othersitting position was acquired in all the cases at follow-up;
motor possibilities improved in 25% of cases;
Complications rate: 41%associated medical pathologies were reduced in 67% of cases.
1996Sussman et al[38]25Cerebral palsyL-rodPosterior fusion and instrumentation from the upper thoracic spine to L5 without anterior fusion provides adequate correction and control of spinal deformity for many patients with cerebral palsy
1997Frischhut et al[39]41Various29 L-rod, Luque-Galveston, CDI and ISOLA; 12 Harrington instrumentation3 deep wound infections Complications rate: 7%
1997Marchesi et al[40]25Duchenne muscular dystrophyL-rod with sacral screwsIn every patient, a good sitting balance could be restored after surgery
Table 5 Decade 2000-2011
Decade-Year of publicationAuthorsPatients(n)Neuromuscular conditionInstrumentationComplications (number of patients)Outcome/Complications
2000-2011
2000Yazici et al[25]47VariousISOLA-Galveston2 deep wound infections;ISOLA-Galveston instrumentation is as safe and effective as other types of instrumentation
2 hardware removals;
4 cases of pseudarthrosis;
1 pseudarthrosis repair
Complications rate: 19%
2009Modi et al[20]52Cerebral palsyU-rod and pedicle screws2 deaths;U-rod with pedicle screws provides good frontal and sagittal plane correction, as well as pelvic obliquity improvement (56% correction)
1 neurologic deficit;
17 respiratory complications (atelectasia, pneumonia, hemothorax)
Complications rate: 38%
2010Nectoux et al[21]28Cerebral palsyLuque-Galveston, U-rod1 case of blindness;
1 death;
16 respiratory complications (atelectasia, pneumonia, pneumothorax)
Complications rate: 64%
2010Modi et al[22]27Spinal muscular atrophy and Duchenne muscular dystrophyU-rod and pedicle screws1 death;Although flaccid neuromuscular scoliosis can be corrected well with U-rod and posterior-only pedicle screws, there is a high rate of associated complications
4 respiratory failure;
2 neurological deficits;
1 ileus;
2 cases of atelectasia;
3 UTIs;
7 cases of coccydynia;
1 rod dislodgement
Complications rate: 77%
2011La Rosa et al[24]84Cerebral palsyUniversal clamps, hooks and L-rod5 respiratory complications
Complications rate: 6%