Comparison of survival analysis between surgical and non-surgical treatments in Duchenne muscular dystrophy scoliosis

Yang, Jae‐Ho; Kim, Ki-Song; Lee, Gi-Hoon; Kim, Hak-Sun

doi:10.1016/j.spinee.2020.06.004

Cited by 12 publications

(18 citation statements)

References 30 publications

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“…1,5,13 The evidence of surgical treatment on pulmonary function in scoliosis has been studied in other patient populations with an evidence of slight increase of forced ventilatory capacity and reduction in loss of lung function because of underlying neuromuscular disorder and progressive scoliosis. 13 Owing to difficulties in conducting pulmonary function testing in nonambulatory individuals with CP, data for this patient group are lacking. As an indirect measure of pulmonary function in children with CP, the incidence of pneumonia has been investigated.…”

Section: Discussionmentioning

confidence: 99%

Mortality and Causes of Death in Children With Cerebral Palsy With Scoliosis Treated With and Without Surgery

Ahonen,

Helenius,

Gissler

et al. 2023

Neurology

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Objectives:To compare mortality and causes of death in scoliotic children with Cerebral palsy (CP) with and without scoliosis surgery.MethodsNational population-based registries were searched for children with CP and scoliosis with and without surgery for scoliosis and were analyzed for comorbidities, mortality, and causes of death.Results:Two hundred and thirty-six had not been operated and 238 had been operated for scoliosis during the median follow-up of 17.8 (IQR 11.7-25.7) and 23.0 (IQR 18.4-28.2) years, respectively. Both groups had similar comorbidities. During the follow-up mortality was higher in the non-surgically treated group than in the surgically treated group (n=38/236, 16% and 8.7 per 1000 follow-up years vs. n=29/238, 12% and 5.3 per 1000 follow-up years, p=0.047). In patients with non-surgical treatment cause of death was respiratory in 76.3% (29/38) and 37.9% (11/29) in patients with surgical treatment of scoliosis (6.6 and 2.0 per 1000 follow-up years, p=0.002). Neurological causes of death were more common in surgically treated patients than in non-surgically treated patients, 44.8% (13/29) and 15.8% (6/38), respectively (3.0 and 1.1 per 1000 follow-up years, p=0.009).Discussion:Surgical treatment of scoliosis associates to reduced mortality due to respiratory causes in children with cerebral palsy and scoliosis.Classification of Evidence:This study provides Class IV evidence of the effects of spinal fusion on mortality of children with severe scoliosis due to CP.

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Section: Discussionmentioning

confidence: 99%

Mortality and Causes of Death in Children With Cerebral Palsy With Scoliosis Treated With and Without Surgery

Ahonen,

Helenius,

Gissler

et al. 2023

Neurology

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“…Most studies show improvement in quality of patients and caregivers life and caregivers satisfaction [23][24][25][26] .They did nd that the majority of the patient caregivers felt that those patients treated surgically was more comfortable than those who were not. Not all research results demonstrated signi cant changes in quality of life of the patients or improvement in vital signs 27 .…”

Section: Long-term Results Ofmentioning

confidence: 99%

The frontal and sagittal patterns of neuromuscular spine deformities depending on the nosological profile

Filatov

Sergeenko

Savin

et al. 2022

Preprint

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Study Design: A prospective single-center study. Level of Evidence IVPurpose: To reveal frontal and sagittal patterns of spinal deformity depends on neuromuscular nosology for surgery and outcomes planning.Methods: The evaluation criteria were: age, gender of patients, volume of blood loss, duration of hospital stay, measurement of the deformity curve, thoracic kyphosis and lumbar lordosis (Cobb angle), pelvic obliquity relative to the horizontal line, the percentage of the curve correction. The Cobb angle was measured preoperatively, prior to discharge from the hospital (up to 21 postoperative days) and one year after surgery.Results: The cohort of 71 patients with spinal deformities due to neuromuscular diseases included four groups: muscular dystrophy (MD), spinal muscular atrophy (SMA), Duchenne muscular dystrophy (DMD) and cerebral palsy (CP). The most characteristic deformity in the frontal plane was C-shaped thoracolumbar scoliosis with the pelvis rotation, rotation of the vertebrae increased according to the magnitude of scoliosis. Lumbar hyperlordosis were common for CP patients, whereas decreased thoracic kyphosis or even thoracic lordosis occurs more frequently in DMD patients. Moderate scoliosis correction was noted in all groups. There was no significant improvement in functional status according to FIM.Conclusion: The findings showed that rigid hyperlordosis the key problem of spinal deformities in neuromuscular patients. Scoliosis and pelvic obliquity can be well corrected in NMS by pedicle screw construction with standard maneuvers and pelvic screw fixation.

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“…Surgical treatment can relieve back pain, improve sitting posture, and facilitate patient care. 6,9,10 Surgery involves a posterior spinal fusion with or without distal extension to include the lumbosacral junction. The decision to incorporate the sacrum in the fusion with pelvic fixation of the rods is recommended in the presence of severe preoperative spinopelvic misalignment producing poor sitting balance.…”

Section: F I G U R Ementioning

confidence: 99%

“…4,5 There is limited data on the survival of patients with DMD after spinal deformity correction. 6,7 This information would be very useful for the individuals and their families as part of decision-making regarding the need and anticipated benefits of scoliosis surgery.The aim of this study was to determine survival rates in individuals with DMD who developed spinal deformity and underwent scoliosis correction, as well as to define the hazard ratio for exposure variables that could affect the outcome of long-term survivorship in this group.…”

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confidence: 99%

Survival of patients with Duchenne muscular dystrophy who underwent spinal deformity correction

Arshad

2023

Develop Med Child Neuro

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AimWe investigated survival rates after scoliosis correction in individuals with Duchenne muscular dystrophy (DMD) and evaluated factors that can affect them.MethodThis was a retrospective cohort study from 2000 to 2022 with a minimum 2‐year postoperative follow‐up. We reviewed the hospital records/spinal radiographs and analysed data with XLSTAT. Kaplan–Meier and multivariate Cox regression survival analysis was performed.ResultsForty‐three patients had a mean age at surgery of 14 years 5 months. Mean postoperative follow‐up was 10 years 10 months. There was no operative or 30‐day postoperative mortality in this group. Twenty‐four patients died because of cardiorespiratory failure. Median survivorship was 14 years 2 months, with the longest observed survival being 22 years 6 months given the limitation of the length of postoperative follow‐up. The degree of preoperative coronal imbalance and pelvic obliquity, as well as intraoperative blood loss, were factors that significantly affected survival. The impact of preoperative sagittal imbalance and extension of the fusion to the sacrum/pelvis trended towards significance. In contrast, age at surgery, preoperative/postoperative scoliosis, thoracic kyphosis, lumbar lordosis, scoliosis and pelvic obliquity flexibility or correction indices, postoperative coronal/sagittal balance, need of preoperative non‐invasive ventilation, preoperative feeding disorders, development of surgical complications, and length of hospital and intensive care unit stay were exposure variables that did not affect postsurgical survival in patients with DMD.InterpretationSurvival of up to two decades or more was possible among young patients with DMD after scoliosis correction. This was affected by factors that related to disease and deformity severity, as well as surgical morbidity.

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Comparison of survival analysis between surgical and non-surgical treatments in Duchenne muscular dystrophy scoliosis

Cited by 12 publications

References 30 publications

Mortality and Causes of Death in Children With Cerebral Palsy With Scoliosis Treated With and Without Surgery

Mortality and Causes of Death in Children With Cerebral Palsy With Scoliosis Treated With and Without Surgery

The frontal and sagittal patterns of neuromuscular spine deformities depending on the nosological profile

Survival of patients with Duchenne muscular dystrophy who underwent spinal deformity correction

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