Author/Editor		Košak, Robert; Travnik, Ludvik; Gorenšek, Miro; Vengust, Rok
Title		Skolioze pri nevro-mišičnih boleznih
Translated title		Scoliosis at neuro-muscular diseases
Type		članek
Source		In: Komadina R, Stahovnik A, editors. 5. Celjski dnevi. Zbornik izbranih predavanj simpozija o poškodbah in okvarah hrbtenice; 2005 apr 8-9; Celje. Celje: Splošna bolnišnica Celje,
Publication year		2005
Volume		str. 71-7
Language		slo
Abstract		The term neuro-muscular scoliosis is used to describe curvature of the spine in children with any disorder of the neuro-muscular system. Common categories include cerebral palsy, myelodysplasia, muscular dystrophies, spinal cord tumours and injuries, spinal muscular atrophy and so forth. Most of these children have as a unifying feature weakness of the trunk, As they grow and their trunk gets weaker, there is a progressive, collapsing deformity of the spine producing a long, C-type curve. These curves tend to be progressive, with the rate of progression becoming worse during rapid growth. For children confined to a wheel chair, progressive curves may affect the child's ability to be seated comfortably, thereby affecting their quality of life and function. The treatment of neuro-muscular scoliosis must be individualized. Bracing may provide support for the trunk in the seated position, but is usually not effective af stopping progression of the curve over time. Seating modifications such as inserts into wheelchairs may help with positioning the child, but are also not corrective in terms of the scoliosis. The surgical principles in the management of neuro-muscular scoliosis differ from those in idiopathic scoliosis. Fusion is necessary at a younger age, and the fused portion of the spine is longer. Fusion to the sacrum is fairly common because many of these children do not have sitting balance or have pelvic obliquity. Combined anterior and posterior fusion is common in the treatment of patients with neuromuscular scoliosis, either because posterior elements are absent, as in myelodysplasia, or because it is necessary to gain correction in a rigid lumbar or thoracolumbar curve and achieve a spine fused in balance over a level pelvis. The instrumentation used is segmental, with either a multiple hook-rod system with or without addition of sublaminar wires or a Luque rod and sublaminar wires. (Abstract truncated at 2000 characters).
Descriptors		NEUROMUSCULAR DISEASES SCOLIOSIS