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Background: Spinal deformities are common complications in paediatric neuromuscular disorders (NMDs), with variability in prevalence, predictors, and outcomes across conditions. A cross-diagnostic synthesis is needed to guide surveillance and management. Objective: To systematically review and meta-analyse the prevalence, predictors, and management outcomes of spinal deformities in children with NMDs. Methodology: This review followed PRISMA 2020 guidelines. MEDLINE, Embase, Cochrane Library, CINAHL, and Web of Science were searched from inception. Observational studies and trials reporting radiographically confirmed spinal deformity (Cobb ≥10°) in individuals ≤18 years with NMDs were included. Random-effects meta-analysis using DerSimonian-Laird with Freeman-Tukey transformation pooled prevalence estimates. Heterogeneity was assessed using I², and certainty of evidence using GRADE. Results: Sixteen studies met inclusion criteria, with thirteen contributing prevalence data. The pooled prevalence of scoliosis was approximately 60%, with substantial heterogeneity. Diagnosis-specific estimates were 45–50% in cerebral palsy, 75–80% in Duchenne muscular dystrophy, and 70–85% in spinal muscular atrophy. Severe scoliosis (Cobb ≥40°) occurred in about 20% of cerebral palsy cases. Non-ambulatory status and higher functional severity (GMFCS IV–V) predicted progression. Surgical correction improved radiographic outcomes, but complication rates remained high (30–33%), predominantly pulmonary (20–25%). Conclusion: Spinal deformity affects most children with NMDs, especially those with severe impairment. While surgery improves alignment, complication risks are considerable. Early, diagnosis-specific surveillance and multidisciplinary care are essential to optimise outcomes.
Onyebuchi et al. (2026) studied this question.
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