Surgical Stabilization of the Spine in Duchenne Muscular Dystrophy

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Abstract
The problem of real distress from the discomfort of collapsing scoliosis is predictable in Duchenne muscular dystrophy (DMD). Once the lumbar curve has exceeded 35.degree., further progression is inevitable. A vital capacity, then, of 35% or more permits consideration of spinal surgery. Using these indications, 24 patients with DMD had long Harrington instrumentations and spinal fusions from S1 up to the upper thoracic spine (T4, 5 or 6). After 2 wk recumbent, they were mobilized wearing a light spinal support in their wheelchairs. The complications encountered are described in detail. One patient died 2 yr after his operation from dystrophic cariomyopathy. With a follow-up period of 4-42 mo., the rest of these patients are well and sitting with comfort. Evidently, prophylactic spinal fusion deserves consideration in the care planned for these patients.

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