1,825 results match your criteria: "Neuromuscular Scoliosis"

Spinal presentations in children with spinal muscular atrophy type 1 following gene therapy treatment with onasemnogene abeparvovec - The SMA REACH UK network experience.

Neuromuscul Disord

November 2024

Department of Paediatric Neurology - Neuromuscular Service, Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Randall Centre for Cell and Molecular Biophysics, Muscle Signalling Section, Faculty of Life Sciences and Medicine, King's College London, London, UK. Electronic address:

Spinal muscular atrophy (SMA) is a neuromuscular disorder of mainly early onset and variable severity. Prior to the introduction of disease modifying therapies (DMTs), children with SMA type 1 typically died before 2 years of age and management was primarily palliative. Onasemnogene abeparvovec (OA), nusinersen, and risdiplam are novel DMTs which ameliorate the effects of the underlying genetic defect at least partially making SMA a treatable condition.

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  • Magnetic controlled growing rods (MCGRs) combined with a sacro-bi-iliac "T-construct" show promising results in correcting early onset neuromuscular scoliosis in non-walking patients, aiming to maintain pelvic balance over time.
  • A study involving 18 patients highlighted significant improvements in spinal curvature and pelvic tilt after surgery, with average corrections of 33.2° and 11°, respectively.
  • Despite a 35% complication rate (mostly mechanical), the study suggests that while some spinal correction was lost over time, pelvic stability was maintained, indicating a need for ongoing monitoring and possible interventions.
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  • Duchenne muscular dystrophy (DMD) is a disease that causes weakness in the muscles and sometimes makes it hard for patients to swallow, leading to the need for a feeding tube called a gastrostomy.
  • In a study at Kobe University Hospital, researchers looked at medical records from patients with DMD over many years to find out how often they needed a gastrostomy and how well they did after getting one.
  • They found only a few patients needed the feeding tube, and some had serious complications afterward, which shows that careful planning is very important for helping these patients live better lives.
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  • * A review of 486 patient charts over nine years showed a significant increase in compliance with the TXA dosing protocol after its implementation, particularly among those with idiopathic conditions.
  • * While idiopathic patients saw reductions in both cell saver and packed red blood cell transfusions, neuromuscular patients had compliance improvements but did not show a significant decrease in transfusion needs.
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  • A middle childhood boy with arthrochalasia Ehlers-Danlos syndrome was diagnosed with scoliosis when he was a toddler, showing a significant 43.6° curvature in spinal radiographs.
  • His treatment started at a children's hospital where he was fitted with a Boston brace, but due to the high chance of his condition worsening, MAGEC growing rods were initially suggested.
  • Ultimately, the family and specialist decided on the Wood-Rigo-Cheneau derotational brace as an alternative treatment approach.
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Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis in children older than 10 years in the United States. AIS is defined as a lateral spine curvature of 10° or more in the coronal plane, without congenital or neuromuscular comorbidities. The U.

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Dyspnea is a common symptom in neuromuscular disorders and, although multifactorial, it is usually due to respiratory muscle involvement, associated musculoskeletal changes such as scoliosis or, in certain neuromuscular conditions, cardiomyopathy. Clinical history can elicit symptoms such as orthopnea, trepopnea, sleep disruption, dysphagia, weak cough, and difficulty with secretion clearance. The examination is essential to assist with the diagnosis of an underlying neurologic disorder and determine whether dyspnea is from a cardiac or pulmonary origin.

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Topical vancomycin powder for the prevention of surgical site infections in spinal deformity surgery: a systematic review and meta-analysis.

Eur Spine J

December 2024

Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing University, Zhongshan Road 321, Nanjing, 210008, China.

Purpose: To assess the effectiveness and safety of topical vancomycin powder (VP) in preventing surgical site infections (SSIs) in spinal deformity surgeries.

Methods: A literature search was conducted on Web of Science, PubMed, and Cochrane Library databases for comparative studies of VP in spinal deformity surgeries published before February 2024. Two reviewers independently screened eligible articles based on the inclusion and exclusion criteria, assessed study quality, and extracted data.

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  • Spinal muscular atrophy (SMA) is a genetic disorder caused by the loss or mutation of the SMN1 gene, leading to muscle weakness and neuromuscular symptoms.* -
  • Recent advancements in SMA treatment have introduced three new therapies, including Risdiplam and Nusinersen, but patients still face challenges like muscle fatigue and limited mobility.* -
  • A study analyzing muscle tissue from Type II SMA patients revealed mitochondrial dysfunction and cellular stress, suggesting potential new targets for future combination therapies.*
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Secondary outcomes of scoliosis surgery in disease-modifying treatment-naïve patients with spinal muscular atrophy type 2 and nonambulant type 3.

Muscle Nerve

November 2024

Dubowitz Neuromuscular Centre, NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, & Great Ormond Street Hospital Trust, London, UK.

Article Synopsis
  • - This study investigates the effects of scoliosis surgery on various outcomes (respiratory function, motor function, weight, pain, and patient satisfaction) in patients with spinal muscular atrophy (SMA), highlighting the lack of research on these secondary outcomes.
  • - Results showed significant improvement in respiratory function for SMA2 patients postsurgery, but some experienced drops in gross motor scores and weight, with many reporting postsurgical pain, especially hip-related.
  • - Despite these challenges, patients and parents expressed overall satisfaction with the surgery's impact on posture and appearance, emphasizing the need for better postoperative care, including physiotherapy and support services.
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A Multicenter Cross-Sectional Study of the Swiss Cohort of LAMA2-Related Muscular Dystrophy.

J Neuromuscul Dis

September 2024

Division of Neuropediatrics and Developmental Medicine, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.

Article Synopsis
  • LAMA2-related muscular dystrophy (LAMA2-RD) is a genetic disorder that affects muscle function and is commonly seen in congenital cases; there is a focus on developing new therapies and understanding its epidemiology.
  • The study analyzed a baseline cohort of 18 patients in Switzerland using data from the Swiss Registry for Neuromuscular Disorders, examining various diagnostic and clinical factors related to their health.
  • Findings revealed that most patients (14) had the severe form of the disease with early onset symptoms, highlighting significant brain abnormalities in many cases, underscoring the complexity and variability of LAMA2-RD.
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Background: The STOP questionnaire was developed to document reasons for discontinuation of growth-friendly (GF) treatment in early onset scoliosis (EOS). This study investigated the incidence of parental request (PR) on the STOP questionnaire and compared clinical information and Early Onset Scoliosis 24-Item Questionnaire (EOSQ-24) scores of PR patients with those whose parents did not request discontinuation (non-parent request [NPR]).

Materials And Methods: An international pediatric spine registry was queried for EOS patients with STOP questionnaires completed by their surgeon.

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Background: LAMA2-related muscular dystrophy (LAMA2-MD) and SELENON-related myopathy (SELENON-RM) are two rare neuromuscular diseases characterized by proximal and axial muscle weakness, scoliosis, spinal rigidity, low bone quality and respiratory impairment. Cardiac involvement has previously been described in retrospective studies and case reports, but large case series and prospective studies in unselected cohorts are lacking.

Objective: The objective of this study is to conduct prevalence estimations, perform cardiac phenotyping, and provide recommendations for clinical care.

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"Ultralow-dose" CT Without Sedation in Pediatric Patients With Neuromuscular Scoliosis.

J Pediatr Orthop

January 2025

Division of Orthopaedic Surgery, Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Article Synopsis
  • This study investigates the feasibility of using ultralow-dose CT (ULD CT) without sedation for pediatric patients with neuromuscular scoliosis undergoing surgery, aiming to reduce surgical risks associated with their anatomical challenges.
  • Fourteen patients participated, with results showing that ULD CT provides a comparable radiation dose to preoperative X-rays and offers high-quality imaging for surgical planning.
  • The study concluded that ULD CT without sedation is a viable option for this patient group, ultimately enhancing anatomical assessments and reducing complications during surgery.
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Introduction: We aimed to implement the enhanced recovery after surgery (ERAS) protocol for pediatric neuromuscular scoliosis (NMS) surgery and to examine the effectiveness of this program in this study.

Methods: Subjects were children with NMS who underwent scoliosis surgery at our department by a surgeon using a single posterior approach. A series of 27 cases before the introduction of ERAS and 27 cases during program stabilization were included in the study.

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  • Scoliosis progression has been noted in adults with cerebral palsy (CP), prompting a systematic review to examine untreated cases post-skeletal maturity, measure annual curve increase, and identify influencing factors.
  • A literature search yielded 15 relevant studies with 2,569 participants, highlighting that scoliosis curves generally continued to progress after skeletal maturity.
  • Key risk factors for progression included greater curve magnitude at adolescence and severe motor deficits, leading to up to 74% curve progression in at-risk patients, averaging an annual increase of 1.4 to 3.5 degrees.
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Background: Approximately 50% of patients with congenital scoliosis will require surgical treatment to prevent further progression. Outcomes following congenital scoliosis are sparse in the literature. The purpose of this study was to identify independent risk factors associated with unplanned readmission and prolonged length of stay (LOS) in patients undergoing primary surgical treatment for congenital scoliosis.

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  • At 12 months, apitegromab showed improved motor function and a favorable safety profile in patients with Type 2 or 3 spinal muscular atrophy (SMA); this study reports on the extended effects after 36 months for nonambulatory patients.
  • In the open-label extension of the study, 35 nonambulatory patients received apitegromab and were evaluated using various assessments, resulting in significant improvements in motor scores and caregiver-reported outcomes over 36 months.
  • The positive effects of apitegromab observed at 12 months were maintained at 36 months, with common side effects including fever, nasopharyngitis, and respiratory infections, but no new safety concerns were identified. *
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  • The study investigates the effectiveness of integrating pelvic rotation correction through proprioceptive neuromuscular facilitation (PNF) with traditional Schroth exercises in treating mild adolescent idiopathic scoliosis (AIS).
  • In a randomized controlled trial with 42 patients, the experimental group received additional PNF sessions alongside standard Schroth exercises over 24 weeks.
  • Results showed significant improvements in hipbone width ratio and trunk rotation for the experimental group, but other outcomes like Cobb angle and self-image changes were not statistically significant.
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  • * A review of surgeries at two different centers revealed that a majority of these patients (75.4%) develop post-operative fevers, but additional testing typically did not provide useful information.
  • * The research suggested that children managed under an accelerated discharge pathway had fewer PICU admissions and associated fever work-ups, indicating that such pathways could reduce unnecessary hospital stays and related complications.
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  • Recent advancements in diagnosis and treatment have transformed the management of spinal muscular atrophy (SMA), leading to new patient classifications based on functional levels: non-sitters, sitters, and walkers.
  • Despite these improvements, patients still face structural issues like scoliosis and joint contractures, which hinder their motor skill development and highlight the need for ongoing monitoring.
  • A study involving 34 SMA patients assessed structural and functional changes over 12 months, revealing non-significant structural deterioration but a general trend of functional improvement, underscoring the importance of including structural evaluations in routine assessments.
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  • Early-onset scoliosis (EOS) is diagnosed in children under 10 and surgery aims to stop curvature progression, improve correction, and support spinal growth, with magnetically controlled growing rods (MCGRs) as a treatment option.
  • A study with 161 patients investigated complications from MCGR surgery and assessed their quality of life, using the EOSQ-24 questionnaire for evaluation.
  • Results showed a 66% complication rate, with 26% of patients needing revision surgery, and emphasized that certain groups (like those with neuromuscular scoliosis and severe curvature) are at higher risk, indicating that reducing elective surgeries could improve overall satisfaction and quality of life.
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This study aims to collect and analyze adverse event (AE) reports related to Nusinersen from the FAERS database. The study employed a combination of signal quantification techniques, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS), to enhance the accuracy of signal detection and reduce the risk of false positives or negatives. Between the first quarter of 2017 and the third quarter of 2023, the FAERS database collected a total of 11,485,105 drug AE reports, of which 5772 were related to Nusinersen.

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Background: SMA is a hereditary neuromuscular disease that causes progressive muscle weakness and atrophy. Several studies have shown that the burden of SMA is very high at many levels. Functional assessment tools currently used do not completely address the impact of the disease in patients' life.

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