Instrumented arthrodesis for Duchenne muscular dystrophy scoliosis improves activity levels

Functional outcomes for patients with Duchenne muscular dystrophy scoliosis appeared to have improved after surgery compared to patients who were treated conservatively without surgery.

“Patients with Duchenne muscular dystrophy scoliosis who have surgery have improvement in activities of daily living compared with patients treated conservatively and the improvement in the activities of daily living is mainly related to sitting ability. The muscle power and forced vital capacity were decreased in both groups at the final evaluation, but the ratio of forced vital capacity deterioration was significantly slowed in the surgical group,” Kyung Soo Suk, MD, and colleagues wrote in their study.

Researchers studied 77 patients with Duchenne muscular dystrophy scoliosis who were about 15 years old. They were referred to the department of orthopaedic surgery at Kyung-Hee University College of Medicine, in Seoul, Republic of Korea, from 2003 to 2010. The patients could not walk and were wheelchair bound at the time, according to the study.

Forty-five patients underwent instrumented spine arthrodesis surgery with CD Horizon instrumentation (Medtronic: Memphis, Tenn.) and 32 patients received conservative treatment with no surgery, Suk and colleagues wrote. Six patients, 3 patient in each group, did not participate in the 2-year follow-up and were not included in final results of the study. Two patients in the surgical group and three patients in the non-surgical group died before the 2-year follow-up.

Suk and colleagues reported the mean Cobb angle was significantly smaller in the surgical group than the non-surgical group at the final follow-up. The surgical group also reported improvement in their activities of daily living and pulmonary function, based on the results.

“Postoperatively, the results on the Muscular Dystrophy Spine Questionnaire (MDSQ) showed that the activities of daily living, especially sitting ability, were markedly improved after spinal surgery in patients with Duchenne muscular dystrophy scoliosis; however, the MDSQ was not available at the time of the initial consultation,” Suk and colleagues wrote.

Disclosure: The researchers report no relevant financial disclosures.

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Source:

Suk K. J Bone Joint Surg Am. 2014. DOI: 10.2106/JBJS.M.00777.