Spinal deformities in patients with spinal muscle atrophy: a review of 36 patients.

Thirty-six patients diagnosed as having spinal muscle atrophy were reviewed. The process was usually recognized in infancy, and spinal deformity commonly developed by age 6, kyphosis developed before age 3, and scoliosis or kyphoscoliosis thereafter. Orthotics may slow progression in most cases, but very young patients must be carefully monitored for chest-wall deformity. Surgery was utilized to stabilize orthotically uncontrollable curves, orthotically controlled curves after maturation, and the severely involved when risks were acceptable. Complications were noted in older or more deformed patients and less frequently in younger, less involved ones. A stabilized spine with head centered over pelvis was usually achieved.