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Surgical management of severe scoliosis with high-risk pulmonary dysfunction in Duchenne muscular dystrophy

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Abstract

Between 2005 and 2007, 14 patients who had severe scoliosis in Duchenne muscular dystrophy (DMD) and a poor forced vital capacity (FVC) of <30% at admission underwent scoliosis surgery. FVC on admission was 21.6% (range, 16–27%). The patients were given respiratory muscle training using a pulmonary trainer (Threshold IMT, Philips Respironics, Inc.) for six weeks before operation. FVC increased to 26.2% (range, 22–31%) the day before operation. The mean preoperative scoliosis was 98° (range, 81°–130°). All patients underwent posterior fusion and all-screw construction and were extubated on the operative day. No patients developed any respiratory complications. The postoperative scoliosis was 34° (range, 20°–40°) (65%). FVC remained stable at six weeks after operation. FVC decreased to 19.8% (range, 16–25%) and the mean scoliosis was 35° (range, 23°–40°)(64%) at two years after operation. DMD patients with severe scoliosis and FVC considered too low to permit reasonable surgical risk could undergo surgery and could benefit from surgery.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, School of Medicine, Kitasato University, Kitasato1-15-1, Sagamihara City, Kanagawa, Japan

    Masashi Takaso, Toshiyuki Nakazawa, Takayuki Imura, Naonobu Takahira & Moritoshi Itoman

  2. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba City, Chiba, Japan

    Kazuhisa Takahashi, Masashi Yamazaki, Seiji Otori, Tsutomu Akazawa, Shohei Minami & Toshiaki Kotani

Authors
  1. Masashi Takaso
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  2. Toshiyuki Nakazawa
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  3. Takayuki Imura
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  4. Naonobu Takahira
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  5. Moritoshi Itoman
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  6. Kazuhisa Takahashi
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  7. Masashi Yamazaki
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  8. Seiji Otori
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  9. Tsutomu Akazawa
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  10. Shohei Minami
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  11. Toshiaki Kotani
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Correspondence to Masashi Takaso.

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Authors’ contributions

MT performed the clinical and radiological evaluation and analyses and drafted the manuscript. All authors edited and approved the final manuscript.

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Takaso, M., Nakazawa, T., Imura, T. et al. Surgical management of severe scoliosis with high-risk pulmonary dysfunction in Duchenne muscular dystrophy. International Orthopaedics (SICOT) 34, 401–406 (2010). https://doi.org/10.1007/s00264-009-0764-7

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  • DOI: https://doi.org/10.1007/s00264-009-0764-7

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