Management of the collapsing spine for patients with Duchenne Muscular Dystrophy

Instrumented fusion of the collapsing spine has gained widespread acceptanc e for patients with Duchenne Muscular Dystrophy but controversy still exist s on the issue of extending the surgical fusion to sacrum in these patients . This retrospective study reviews the long-term outcome of a group of patien ts with spinal deformity associated with Duchenne Muscular Dystrophy who we re managed with long spinal fusion to L5 and ongoing wheelchair seating att ention. The clinical notes and radiographs of 19 consecutive patients were reviewed. Fifteen patients attended for clinical and radiological assessmen t at a mean of 28 months post operatively. The surgery for these patients involved a mean anaesthetic time of 3.5 h an d a mean transfusion requirement of 5 units of red cell concentrate. At lon g-term follow-up 15 patients continued to sit in a well-balanced position. Surgical fusion of the spine to L5 combined with ongoing attention to seati ng is associated with good long-term functional results in these patients.