Development of scoliosis in myelomeningocele. Differences in the history caused by idiopathic pattern

The natural history of scoliosis in the literature concerning the idiopathic and neuromuscular scoliosis in myelomeningocele patients (MMC) are compared to our own results in 12 patients with MMC and 89 patients operated because of an idiopathic scoliosis. According to known experiences the natural history of scoliosis in MMC is progression even after the end of growth. The chance of developing a scoliosis increases with the patients, age and the level of the lesion. The higher the level of paralysis the more common is a spinal deformity. In literature the progression rate of MMC scoliosis is 2.5-3.5 degrees per year, with the idiopathic pattern 0.5-0.65 degrees per year after end of growth. Our own results of surgically treated patients show a rate of progression of 6.2 degrees per year in MMC. The surgical treatment must start before a severe spinal deformity has developed because of the higher rate of operative complications.