Surgical Strategies for Cervical Deformities Associated With Neuromuscular Disorders

• Published in: Neurospine Vol. 17; no. 3; pp. 513 - 524
• Main Authors: Lee, Jong Joo, Oh, Sung Han, Jeong, Yeong Ha, Park, Sang Man, Jeon, Hyeong Seok, Kim, Hyung-Cheol, An, Seong Bae, Shin, Dong Ah, Yi, Seong, Kim, Keung Nyun, Yoon, Do Heum, Shin, Jun Jae, Ha, Yoon
• Format: Journal Article
• Language: English
• Published: Korean Spinal Neurosurgery Society 01.09.2020; 대한척추신경외과학회
• Subjects: abnormal involuntary movement; cervical deformity; neuromuscular disorders; Review; 신경외과학
• ISSN: 2586-6583; 2586-6591
• DOI: 10.14245/ns.2040464.232

Neuromuscular disorders (NMDs) are diseases involving the upper and lower motor neurons and muscles. In patients with NMDs, cervical spinal deformities are a very common issue; however, unlike thoracolumbar spinal deformities, few studies have investigated these disorders. The patients with NMDs have irregular spinal curvature caused by poor balance and poor coordination of their head, neck, and trunk. Particularly, cervical deformity occurs at younger age, and is known to show more rigid and severe curvature at high cervical levels. Muscular physiologic dynamic characteristics such as spasticity or dystonia combined with static structural factors such as curvature flexibility can result in deformity and often lead to traumatic spinal cord injury. In addition, postoperative complication rate is higher due to abnormal involuntary movement and muscle tone. Therefore, it is important to control abnormal involuntary movement perioperatively along with strong instrumentation for correction of deformity. Various methods such as botulinum toxin injection, physical therapy, muscle division technique, or intrathecal baclofen pump implant may help control abnormal involuntary movements and improve spinal stability. Surgical management for cervical deformities associated with NMDs requires a multidisciplinary effort and a customized strategy.