History and Physical Examination

Evaluation of a patient with neuromuscular scoliosis entails a thorough assessment of all body systems. Accurate diagnosis of the underlying disease entity is essential and may require muscle biopsy.

Assessing nutritional status and pulmonary function is extremely important. The child's caregivers should be interviewed to gain an appreciation of the patient's functional level. The orthopedic examination includes assessment of all extremities and joints for contractures.^[4] Spinal deformity, decompensation, and shoulder balance are documented. Ambulatory status is also evaluated, and patients are classified as walkers, sitters, or nonsitters.

Workup

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Media Gallery

Neuromuscular scoliosis. Preoperative clinical picture of a young male with severe scoliosis secondary to quadriplegic cerebral palsy.
Neuromuscular scoliosis. Preoperative anteroposterior spinal radiograph of young male with severe scoliosis secondary to quadriplegic cerebral palsy.
Neuromuscular scoliosis. Preoperative lateral spinal radiograph of young male with severe scoliosis secondary to quadriplegic cerebral palsy.
Neuromuscular scoliosis. Postoperative clinical picture of young male with severe scoliosis secondary to quadriplegic cerebral palsy.
Neuromuscular scoliosis. Postoperative anteroposterior spinal radiograph of young male with severe scoliosis secondary to quadriplegic cerebral palsy at 2-year follow-up.
Neuromuscular scoliosis. Postoperative lateral spinal radiograph of young male with severe scoliosis secondary to quadriplegic cerebral palsy at 2-year follow-up.

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Author

Matthew B Dobbs, MD Associate Professor, Department of Orthopaedic Surgery, Washington University School of Medicine

Matthew B Dobbs, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Lawrence G Lenke, MD Jerome J Gilden Professor of Orthopedic Surgery, Section of Spinal Surgery, Director of Residency Program, Washington University School of Medicine; Chief of Spinal Surgery, Department of Orthopedic Surgery, St Louis Shriners Hospital

Lawrence G Lenke, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Scoliosis Research Society, American Medical Association, American Orthopaedic Association, American Spinal Injury Association, Missouri State Medical Association, North American Spine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Jeffrey A Goldstein, MD Clinical Professor of Orthopedic Surgery, New York University School of Medicine; Director of Spine Service, Director of Spine Fellowship, Department of Orthopedic Surgery, NYU Hospital for Joint Diseases, NYU Langone Medical Center

Jeffrey A Goldstein, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Association, AOSpine, Cervical Spine Research Society, International Society for the Advancement of Spine Surgery, International Society for the Study of the Lumbar Spine, Lumbar Spine Research Society, North American Spine Society, Scoliosis Research Society, Society of Lateral Access Surgery

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Globus, 3Spine<br/>Received income in an amount equal to or greater than $250 from: Globus, Nuvasive, Surgalign, 3Spine.

Additional Contributors

Lee H Riley III, MD Chief, Division of Orthopedic Spine Surgery, Associate Professor, Departments of Orthopedic Surgery and Neurosurgery, Johns Hopkins University School of Medicine

Disclosure: Nothing to disclose.

William O Shaffer, MD Former Orthopedic Spine Surgeon, Northwest Iowa Bone, Joint, and Sports Surgeons

William O Shaffer, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, International Society for the Study of the Lumbar Spine, Kentucky Medical Association, Kentucky Orthopaedic Society, North American Spine Society, Southern Medical Association, Southern Orthopaedic Association

Disclosure: Nothing to disclose.

Neuromuscular Scoliosis Clinical Presentation

History and Physical Examination

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