The treatment of scoliosis in muscular dystrophy using modified Luque and Harrington-Luque instrumentation

We have treated 101 patients with scoliosis secondary to muscular dystrophy over a 13-year period; 64 had Duchenne's muscular dystrophy, 33 spinal mus cular atrophy and four congenital muscular dystrophy. The patients underwent a modified Luque (87) or Harrington-Luque instrument ation (14) combined with a limited Moe fusion in all except 27 cases. A mea n of 13 levels was instrumented. The mean preoperative sitting Cobb angle w as 84 degrees (10 to 150) and the mean postoperative angle 40 degrees (52% correction). Most patients (96%) were able to discard their braces and ther e was a high level of patient satisfaction (89.6%). Less correction was seen for severe curves, and there was a greater recurre nce of postoperative pelvic tilt in those patients not instrumented to the sacrum, Although the incidence of minor or temporary complications was high , these occurred chiefly in the early high-risk patients with very severe c urves and considerable pre-existing immobility.