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Spinal curvature is a common concern, as it develops in more than 50% of children with spinal muscular atrophy, most commonly in those who are nonambulatory. This may be addressed by surgical correction or positional support (e.g. bracing). The decision to perform surgical correction of complications such as scoliosis is based on the child’s spine curvature, pulmonary function, and bone maturity.1,2

POTENTIAL BENEFITS

CONSIDERATIONS

SURGERY

POTENTIAL BENEFITS

  • May improve sitting posture, balance, endurance, and cosmesis2
  • May slow respiratory decline2,3
  • May increase overall comfort, quality of life, and independence1

CONSIDERATIONS

  • May impact ability to perform lumbar puncture
  • Optimal timing of procedure is controversial3
  • Individuals with spinal muscular atrophy may be at higher risk of surgical complications than the general population3

BRACING

POTENTIAL BENEFITS

  • May improve sitting balance, endurance, and overall physical appearance3
  • More conservative approach than surgery that allows for further growth3

CONSIDERATIONS

  • Likely does not prevent or delay development of scoliosis3
  • May cause some discomfort1
  • Lung function may be adversely affected by rigid bracing in children ≤8 years of age
  • Expiratory lung volume may be lower with bracing4
Muscular Atrophy

The clinical spectrum of SMA is highly variable and often requires comprehensive medical care involving multiple disciplines.2