Spinal Fusion in Duchenne's Muscular Dystrophy

Radiographic and Functional Outcome After Surgical Management of Severe Scoliosis in Skeletally Immature Patients with Muscular Dystrophy

“…However, the average age of our patients was 10.4 years. The mean Cobb angle showing the severity of scoliosis in these patients was 80°, which was above the values reported in other studies, 1,13,20,21 indicating severe spinal deformity. Furthermore, FVC representing pulmonary function also decreased to 48%.…”

“…Although this 2% decrease is small in comparison with the 4% decrease/year reported by Kurz et al 5 in patients with MD scoliosis in conjunction with spinal deformity, surgery could not prevent the deterioration of FVC. Also, in other studies, 1,4,12,13,20,21 the level of subjective satisfaction with the body image perceived by the patients and their guardians was high (9/10) after the surgery, probably owing to the severe deformity having been corrected in the appearance.…”

“…Despite the fact that these patients had severe deformity, the mean Cobb angle correction value of 61% and spinopelvic fixation value of 75% were not significantly different from those reported in other studies. 12,13,21 Furthermore, the amount of bleeding was low, being 1111 mL. Except for mechanical ventilation done for 3 days in one patient due to pulmonary edema, there were no postoperative complications such as neurologic injuries and infections.…”

Respiratory Care of the Patient with Duchenne Muscular Dystrophy

“…There are no absolute contraindications for surgery based on pulmonary function; some report good results even in patients whose FVC is 20% of predicted (75,76). Best prognosis for recovery seems to be FVC Ͼ 40% (77), although others use the absolute vital capacity of Ͻ 1,900 ml as an indicator of rapid progression of scoliosis and poor prognosis (78).…”

Correction of Neuromuscular Scoliosis in Patients With Preexisting Respiratory Failure

“…Most research is in patients with Duchenne muscular dystrophy or spinal muscular atrophy. [1][2][3][4][5][6] Most of this literature suggests that respiratory function following surgery initially deteriorates before returning to preoperative levels, and then it gradually deteriorates with progression of the underlying neuromuscular disease.…”