Spinal Stabilization in Duchenne Muscular Dystrophy: Principles of Treatment and Record of 31 Operative Treated Cases

Pedicle Screw-only Constructs With Lumbar or Pelvic Fixation for Spinal Stabilization in Patients With Duchenne Muscular Dystrophy

“…14 Recent newer hybrid instrumentation techniques use pedicle screws or hooks along with sublaminar wires. 14,19,[21][22][23] Using hybrid instrumentation techniques, although a good coronal deformity correction rate of 41% to 66% has been reported, up to 21% hardware-related complications and 10% pseudarthrosis rate have been reported. [22][23][24] Junctional kyphosis and increasing thoracic kyphosis (>10 degrees) have also been reported in up to 22% of cases owing to the lesser stiffness of sublaminar wires used in the thoracic spine.…”

“…Harrington rod instrumentation, which was used in 1970s, resulted in loss of thoracic kyphosis and lumbar lordosis. 18,19 Segmental stabilization became available with the introduction of Luque system and has been universally accepted as providing better results than the Harrington system. 6,20 Segmental fixation distributes the correction forces across all segments and is recommended in curves of neuromuscular etiology owing to the associated osteopenia.…”

Prevalence of smooth muscle dysfunction among children with Duchenne muscular dystrophy

“…Although the disease by itself does not cause major bleeds, increased operative blood losses have been observed in previous studies 22,23 . DMD patients are at increased risk of undergoing spinal surgery due to progressive scoliosis 24,25 .…”

Surgical Treatment of Neck Hyperextension in Duchenne Muscular Dystrophy by Posterior Interspinous Fusion

“…1,2,4,5 In case of rapidly progressive deformity, the scoliotic curve decreases the respiratory function (already severely compromised by the myopathy) and makes sitting difficult and uncomfortable, worsening quality of life of these patients. 1,4,[5][6][7][8][9] Surgical correction of progressive scoliosis in patients with DMD consists of spinal fusion from the upper thoracic spine to the sacrum, using different techniques/instrumentations. 1,3,[5][6][7][8]10,11 The advantages of this kind of surgery are primarily linked to an improvement of quality of life; indeed, patients sit more comfortably and for many hours a day, which is crucial considering that they are all wheelchair-bound.…”

“…1,4,[5][6][7][8][9] Surgical correction of progressive scoliosis in patients with DMD consists of spinal fusion from the upper thoracic spine to the sacrum, using different techniques/instrumentations. 1,3,[5][6][7][8]10,11 The advantages of this kind of surgery are primarily linked to an improvement of quality of life; indeed, patients sit more comfortably and for many hours a day, which is crucial considering that they are all wheelchair-bound. In addition, surgery makes nursing easier, provides cosmetic improvement, and reduces back pain.…”