Spinal Deformities in Paediatric Neuromuscular Disorders: A Systematic Review and Meta-Analysis of Prevalence, Predictors, and Surgical Outcomes

<p><strong><span lang="EN-GB">Background:</span></strong><span lang="EN-GB"> 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.</span></p> <p><strong><span lang="EN-GB">Objective:</span></strong><span lang="EN-GB"> To systematically review and meta-analyse the prevalence, predictors, and management outcomes of spinal deformities in children with NMDs.</span></p> <p><strong><span lang="EN-GB">Methodology:</span></strong><span lang="EN-GB"> 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.</span></p> <p><strong><span lang="EN-GB">Results:</span></strong><span lang="EN-GB"> 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%).</span></p> <p><strong><span lang="EN-GB">Conclusion:</span></strong><span lang="EN-GB"> 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.</span></p>