Surgical management of severe scoliosis with high risk pulmonary dysfunction in Duchenne muscular dystrophy: patient function, quality of life and satisfaction.
In a previous study, the authors reported the clinical and radiological results of Duchenne muscular dystrophy (DMD) scoliosis surgery in 14 patients with a low FVC of <30%. The purpose of this study was to determine if surgery improved function and QOL in these patients. Furthermore, the authors assessed the patients' and parents' satisfaction. %FVC increased in all patients after preoperative inspiratory muscle training. Scoliosis surgery in this group of patients presented no increased risk of major complications. All-screw constructions and fusion offered the ability to correct spinal deformity in the coronal and pelvic obliquity initially, intermediate and long-term. All patients were encouraged to continue inspiratory muscle training after surgery. The mean rate of %FVC decline after surgery was 3.6% per year. Most patients and parents believed scoliosis surgery improved their function, sitting balance and quality of life even though patients were at high risk for major complications. Their satisfaction was also high.
Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Kitasato 1-15-1, Sagamihara, Kanagawa, Japan. mtakaso@kitasato-u.ac.jp
Masashi
M
Takaso
Toshiyuki
T
Nakazawa
Takayuki
T
Imura
Takamitsu
T
Okada
Kensuke
K
Fukushima
Masaki
M
Ueno
Naonobu
N
Takahira
Kazuhisa
K
Takahashi
Masashi
M
Yamazaki
Seiji
S
Ohtori
Hirotsugu
H
Okamoto
Toshiyuki
T
Okutomi
Makihito
M
Okamoto
Takashi
T
Masaki
Eijyu
E
Uchinuma
Hiroyuki
H
Sakagami
D000293:Adolescent; D001945:Breathing Exercises; D002648:Child; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011788:Quality of Life; D011859:Radiography; D020127:Recovery of Function; D012600:Scoliosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D014797:Vital Capacity