Management of scoliosis in Duchenne muscular dystrophy: a large 10-year retrospective study

Title

Management of scoliosis in Duchenne muscular dystrophy: a large 10-year retrospective study

Creator

Kinali M; Messina S; Mercuri E; Lehovsky J; Edge G; Manzur AY; Muntoni F

Publisher

Developmental Medicine & Child Neurology

Date

2006

Subject

PedPal Lit; Adolescent Comparative Study Decision Making Disability Evaluation Female Humans Male Muscular Dystrophy; Duchenne/complications Postoperative Period Research Support; Non-U.S. Gov't Retrospective Studies Scoliosis/etiology/surgery/therapy Time Factors Treatment Outcome

Description

Scoliosis affects 75 to 90% of patients with non-ambulant Duchenne muscular dystrophy (DMD). Spinal surgery is the treatment of choice but the indication varies among centres. Some offer surgery to all non-ambulant patients, irrespective of scoliosis severity. Early surgery has the advantage of targeting DMD when cardiorespiratory function is preserved, but not all patients develop scoliosis. We report our 10-year experience of scoliosis management in 123 patients with DMD who were at least 17 years old at the time of the study. Scoliosis was absent in 10%, and mild, non-progressive (at least 30 degrees ) in 13% of patients. Another 13% had moderate scoliosis (31-50 degrees ) and were managed conservatively. Surgery was considered in 57% (70/123) of patients with scoliosis greater than 50 degrees and eventually performed in 35%. The remaining patients either refused surgery (9%) or were unfit because of cardiorespiratory compromise (13%). In a further 7%, scoliosis (greater than 50 degrees ), first noted after 14 years of age, was progressing slowly and surgery was not performed. At 17 years there was no difference in survival, respiratory impairment, or sitting comfort among patients managed conservatively or with surgery. One-third (44/123) of our patients were managed satisfactorily without receiving spinal surgery. We provide insight into the natural history of scoliosis in DMD that should help families and clinicians with decision-making when surgery is considered.
2006

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

513-8

Issue

6

Volume

48

Citation

Kinali M; Messina S; Mercuri E; Lehovsky J; Edge G; Manzur AY; Muntoni F, “Management of scoliosis in Duchenne muscular dystrophy: a large 10-year retrospective study,” Pediatric Palliative Care Library, accessed July 23, 2021, https://pedpalascnetlibrary.omeka.net/items/show/13645.

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