How are contractures treated in spinal muscle atrophy (SMA)?

Updated: Nov 05, 2018
  • Author: Ashish S Ranade, MBBS, MS, MRCS; Chief Editor: Jeffrey A Goldstein, MD  more...
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Answer

Joint flexion contractures of the hips and knees are associated with nonambulatory status. Surgical releases are performed; the rate of recurrence is extremely high, especially in sitting patients. Equinus is occasionally present. Ambulatory patients rarely have equinus or cavovarus deformities. Surgical releases are rarely needed for patients with type II or III SMA, because the loss of function is due to weakness and not to contractures. Some form of tendon transfer may be needed in patients with type III SMA to correct foot or ankle functional defects.

Careful patient selection is important for optimal results. Postoperative immobilization should be of shorter duration; prolonged immobilization leads to a decline in motor function. [47, 48]


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