European Spine Journal

, Volume 17, Issue 2, pp 255–261 | Cite as

Scoliosis correction with pedicle screws in Duchenne muscular dystrophy

  • Frederik Hahn
  • Dominik Hauser
  • Norman Espinosa
  • Stefan Blumenthal
  • Kan Min
Original Article

Abstract

This report describes the spinal fixation with pedicle-screw-alone constructs for the posterior correction of scoliosis in patients suffering from Duchene muscular dystrophy (DMD). Twenty consecutive patients were prospectively followed up for an average of 5.2 years (min 2 years). All patients were instrumented from T3/T4 to the pelvis. Pelvic fixation was done with iliac screws similar to Galveston technique. The combination of L5 pedicle screws and iliac screws provided a stable caudal foundation. An average of 16 pedicle screws was used per patient. The mean total blood loss was 3.7 l, stay at the intensive care unit was 77 h and hospital stay was 19 days. Rigid stabilisation allowed immediate mobilisation of the patient in the wheel chair. Cobb angle improved 77% from 44° to 10°, pelvic tilt improved 65% from 14° to 3°. Lumbar lordosis improved significantly from 20° to 49°, thoracic kyphosis remained unchanged. No problems related to iliac fixation, no pseudarthrosis or implant failures were observed. The average percentage of predicted forced vital capacity (%FVC) of the patients was 55% (22–94%) preoperatively and decreased to 44% at the last follow-up. There were no pulmonary complications. One patient with a known cardiomyopathy died intraoperatively due to a sudden cardiac arrest. The rigid primary stability with pedicle screws allowed early mobilisation of the patients, which helped to avoid pulmonary complications.

Keywords

Duchenne muscular dystrophy Scoliosis Pedicle screw instrumentation Pulmonary function Cardiomyopathy 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Frederik Hahn
    • 1
  • Dominik Hauser
    • 1
  • Norman Espinosa
    • 1
  • Stefan Blumenthal
    • 2
  • Kan Min
    • 1
  1. 1.Department of Orthopaedics, Balgrist ClinicUniversity of ZurichZurichSwitzerland
  2. 2.Department of Anaesthesiology, Balgrist ClinicUniversity of ZurichZurichSwitzerland

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