EFFECT OF SPINAL SURGERY ON LUNG-FUNCTION IN DUCHENNE MUSCULAR-DYSTROPHY

Background - The effect on subsequent respiratory function of spinal s tabilisation for scoliosis in Duchenne muscular dystrophy is unclear. In order to clarify this clinical problem, changes in the forced vital capacity of a group of children with Duchenne muscular dystrophy who had undergone spinal surgery were measured and compared with a group o f children with Duchenne muscular dystrophy who had not had surgery. M ethods - In this retrospective study 17 boys with Duchenne muscular dy strophy who underwent spinal stabilisation at a mean age of 14.9 years (surgical group) were compared with 21 boys with Duchenne muscular dy strophy who had not had surgery (non-surgical group). The mean (SD) Co bb angle of the surgical group at 14.9 years was 57 (16.4)degrees, and of the non-surgical group at 15 years was 45 (29.9)degrees. Forced vi tal capacity expressed as percentage predicted (% FVC) was measured in total over a seven year period in the surgical group and over 6.5 yea rs in the non-surgical group, and regression equations were calculated . Survival curves for both groups were also constructed. Results - No difference was found between spinal stabilisation (surgical group) and the non-surgical group in the rate of deterioration of % FVC which wa s 3-5% per year. There was no difference in survival in either group. Conclusions - Spinal stabilisation in Duchenne muscular dystrophy does not alter the decline in pulmonary function, nor does it improve surv ival.