Neuromuscular scoliosis in spina bifida occulta and a transitional lumbosacral vertebra

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A 12-year-old boy was brought to the chiropractor by his mother for a consultation and possible care for the boy’s back pain, progressive scoliosis, and long-standing walking ab- normality that worsened quickly in the past 12 months. His mother stated that the patient walked on the balls of his left foot instead of putting weight on the heel ever since he started learning to walk. He had visited several pediatricians and neurologists since childhood. No one had been able to solve his problems. Radiographs showed right thoracolumbar curve of Cobb angle 20°, left pelvic obliquity, a cleft in the L5 and S1, and articulation of the trans- verse processes of L5 with the bilateral sacral alae. The patient was diagnosed with NMS and functional leg length discrepancy attributed to SBO and a LSTV at L5 level. Multimodal chi- ropractic care and foot orthotics were used. After 18 months of interventions, normal spinal curve, heel-to-toe gait, and posture balance were retrieved successfully. To date, few reports have been published on the impacts of SBO along with LSTV upon the lumbosacral spine.

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