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Clinical Issues in Indication, Correction, and Outcomes of the Surgery for Neuromuscular Scoliosis: Narrative Review in Pedicle Screw Era

 Hak Sun Kim  ;  Ji Won Kwon  ;  Kun-Bo Park 
 NEUROSPINE, Vol.19(1) : 177-187, 2022-03 
Journal Title
Issue Date
Cerebral palsy ; Muscular dystrophy ; Pedicle screws ; Scoliosis
Surgical treatment for neuromuscular scoliosis has evolved with pedicle screw instrumentation and the improvement of perioperative management. We aimed to review recent papers related to posterior surgical correction with a pedicle screw system for neuromuscular scoliosis, particularly cerebral palsy and muscular dystrophy, in terms of indication, correction method, and outcomes. The most remarkable change was the posterior-only operation with all-pedicle screw fixations. With this change, operation time, blood loss, and postoperative complications decreased. Furthermore, spinal osteotomy could be performed with the pedicle screw system for severe scoliosis. S2-alar-iliac screws demonstrated favorable outcomes in terms of stability and complication, but a question remains about saving the mobile segment for sitting balance, interaction between the hip and spine, effect to the sagittal balance, and proximal junctional problem. The quality of life improvement was more definite in patients with cerebral palsy. The improvement of respiratory function in Duchenne muscular dystrophy was not certain, although an increase of spinal height, thoracic cavity size, and absolute forced vital capacity have been reported. Further prospective studies or randomized clinical trials are needed to evaluate the long-term outcomes of lumbosacral fixation, preservation of the lumbosacral joint, or functional improvement considering the different etiology.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ji-Won(권지원) ORCID logo https://orcid.org/0000-0003-4880-5310
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Park, Kun Bo(박건보) ORCID logo https://orcid.org/0000-0002-8839-4870
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