LONGITUDINAL-STUDY OF SPINAL DEFORMITY IN DUCHENNE MUSCULAR-DYSTROPHY

被引:64
作者
ODA, T
SHIMIZU, N
YONENOBU, K
ONO, K
NABESHIMA, T
KYOH, S
机构
[1] Department of Orthopaedic Surgery, Osaka University Medical School
[2] Department of Orthopaedic Surgery, National Toneyama Hospital, Osaka
[3] Department of Neurology, National Toneyama Hospital, Osaka
关键词
DUCHENNE MUSCULAR DYSTROPHY; RESPIRATORY FUNCTION; SPINAL DEFORMITY; SURGERY;
D O I
10.1097/01241398-199307000-00012
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
To investigate the natural course of the spinal deformity in Duchenne muscular dystrophy (DMD) and its clinical relevance, longitudinal series of spinal radiographs and medical records of 46 patients with DMD were reviewed. The natural course of the deformity was classified into three types; type 1 (n = 21), unremittent progression of scoliosis with kyphosis; type 2 (n = 18), transition from kyphosis to lordosis before age 15 years; and type 3 (n = 7), less deformity without prominent longitudinal changes. Age at loss of ambulatory ability was not a predictor of type. Neither was the age at which the Cobb angle was 30-degrees correlated with the rate of subsequent progression. Because the spinal deformity always progresses, we consider spinal surgery justifiable in type 1, when a certain strict indication exists, such as spinal deformity >30-degrees and age <15 years in patients with >35% predicted value of vital capacity. In type 2, operation may be necessary in patients in whom Cobb angle will progress unremittently. There is no surgical indication for patients with type 3.
引用
收藏
页码:478 / 488
页数:11
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