title: Evaluation of the Unit Rod surgical instrumentation in Duchenne scoliosis. A retrospective study.
abstract: The article represents a retrospective clinical and radiological study.Objectives.Evaluating the safety and efficiency of the surgical treatment by using the Unit Rod for scoliosis in adolescents and children presenting Duchenne's muscular dystrophy.Summary.Surgical management of myopathic scoliosis still causes controversies regarding the timing of surgery (patient's age), the pelvic inclusion in the arthrodesis or the advantages of surgery over the conservatory treatment. The patients are very fragile and a long surgery with massive blood loss could lead to serious complications. Unit Rod instrumentation is simple, confers excellent stability and has a low rate of complications.Methods.This is a retrospective clinical and radiological study with a medium follow-up of 6.9 years including 13 patients diagnosed with Duchenne myopathy. All investigated patients were non-ambulatory at the time of surgery and have been treated by the Unit Rod technique at the University Hospital of Rouen between 2002 and 2008. Spinal fusion was, in all cases, realized from T2 to pelvis. Galveston technique of pelvic fixation and Luque's sublaminar wire instrumentation of the spine were used.Results.The results obtained with this treatment and post-surgery complications were analyzed and compared with those from literature. The advantages of this technique consist mostly in a good and stable pelvic fixation, a short interventional time, a minimal blood loss and few complications. Cobb angle correction is similar to that obtained by other surgical procedures.Conclusions.Using the Unit Rod instrumentation of scoliosis in Duchenne's muscular dystrophy is safe, has excellent outcomes, brings post-surgery improvements, and has minor intra and post-surgery complications. The low cost of this treatment could make it a first choice for medical health systems with financial problems.
authors.affiliation: Paediatric Orthopaedics Department, General Hospital, Le Havre, France.
authors.forename: T
authors.initials: T
authors.lastname: Nedelcu
authors.affiliation: Paediatric Orthopaedics Department, Paediatric Physical Rehabilitation Centre Bois Larris, Lamorlaye, France.
authors.forename: I
authors.initials: I
authors.lastname: Georgescu
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications* / Q000601:surgery*; D010388:Pelvis / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012600:Scoliosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014910:Wheelchairs; D055815:Young Adult
keywords: Duchenne; Muscular dystrophy; Unit Rod; scoliosis; vertebral arthrodesis