Narrative review of spinal muscular atrophy (SMA) from an orthopedic perspective, covering classification by type, the pathophysiology of anterior horn cell loss, and management of the two major musculoskeletal complications: progressive neuromuscular scoliosis and hip subluxation/dislocation.
When you see a nonambulatory SMA child with a progressive curve, act early — bracing is futile and respiratory reserve is finite, so refer for spinal surgery before the Cobb angle or lung function closes the window.
For painless hip dislocation in SMA, counsel families toward observation: surgical reduction almost always fails, and the low-tone hip tolerates nonconcentric reduction far better than a spastic one.
Narrative review of spinal muscular atrophy (SMA) from an orthopedic perspective, covering classification by type, the pathophysiology of anterior horn cell loss, and management of the two major musculoskeletal complications: progressive neuromuscular scoliosis and hip subluxation/dislocation.
When you see a nonambulatory SMA child with a progressive curve, act early — bracing is futile and respiratory reserve is finite, so refer for spinal surgery before the Cobb angle or lung function closes the window.
For painless hip dislocation in SMA, counsel families toward observation: surgical reduction almost always fails, and the low-tone hip tolerates nonconcentric reduction far better than a spastic one.