Surgical and long-term functional outcomes of patients with Duchenne muscular dystrophy following spinal deformity correction

Table 5 Clinical and radiographic outcomes of surgical correction of scoliosis in patients with Duchenne muscular dystrophy, the current and previous studies reporting clinical and radiographic outcomes are summarized

Study	Current	Heller	Sengupta		Marsh	Cervellati	Hahn	Mehta	Modi	Takaso	Debnath		Alexander	Duckworth	Suk	Nedelcu	Scannell		Takaso	Yang
Year	2022	2001	2002		2003	2004	2008	2009	2010	2010	2011		2013	2014	2014	2016	2017		2018	2020
Patients (n)	43	31	50		30	20	20	36	18	28	22	18	28	26	40	13	47	13	271	99
Instrumentation (n)	PH/PS/SL or PS	I	L/G or L-rod	L/G or L-rod	C/HL/USS/S	L/CD	PS/G	PS	PS	PS	SL	PS	L/G and/or PS	SL or PS	CD	UR	L	PS	PS	CD
Distal instrumented level [n = (if subset)]	L4 (21), L5 (4), P (18)	SP	P (31)	L5 (19)	P	SP	P	L5 (26); P (10)	L5 (7); SP (11)	L5	P	L5	NA	L4/5 (14); SP (12)	LL (5); P (40)	SP	P	P	L5	LL (5); P (94)
Age at surgery (yr)	14.4	14.1	14	11.7	14.7	13	14	13.5	14.4	13	12.5	11.8	14.2	14.2	14.9	12.7	13	14	13.5	15.1
Pre-op FVC%	NA	54.3	44	58	33	NA	55	NA	NA	NA	57	53	NA	NA	NA	NA	59	48	NA	NA
Post-op FVC%	NA	NA	NA	NA	NA	NA	54	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
FVC% at final F/U	NA	52.7	NA	NA	NA	NA	47	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
Pre-op scoliosis (°)	57.5	48.6	48.4	19.8	61	48	44	71	76.4	74	45.3	42.8	56.4	59	65.5	30	31	43	70	65.8
Scoliosis (initial post-op) (°)	NA	12.5	16.7	3.2	24.2	22	10	25.5	30.1	14	NA	NA	21.6	13	NA	2	16	12	15	NA
Correction of scoliosis (%)	79.2	74.3	66	80	60.3	54.2	77	65	63.3	81	NA	NA	61.7	78	NA	93.3	NA	NA	78.6	50.6
Scoliosis at final F/U (°)	15.6	12.5	22	5.2	NA	28	9	28.5	31.3	17	17.7	7.3	NA	NA	36.2	4.2	21	12	17	32.5
Scoliosis loss of correction (°)	NA	0	5.2	2	NA	6	1	3	1.2	3	NA	NA	NA	NA	NA	2.2	5	0	2	NA
Pre-op pelvic obliquity (°)	16.3	18.2	19.8	8.9	18.1	19.8	14	14.8	18.1	9	14.5	11.2	NA	21	20.7	7.7	7	6	15	21
Pelvic obliquity (initial post-op) (°)	NA	3.8	7.2	2.2	NA	10	3	6.7	8.6	3	NA	NA	NA	3	NA	0.6	5	3	5	NA
Correction of pelvic obliquity (%)	80.8	79.1	63.6	76	NA	49.5	65	54.7	52	66.7	NA	NA	NA	85.7	NA	92.2			66.7	53.8
Pelvic obliquity at final F/U (°)	4.6	5.1	11.6	2.9	NA	NA	3	9.3	8.8	6	5.6	2	NA	NA	11.4	1.5	5	2	6	9.7
Fusion to sacropelvis (%)	41.9	100	100	0	100	100	100	27.8	66.7	0	100	0	NA	46.2	89.9	100	100	100	0	94.9
Duration of surgery (min)	352.1	363	310	240	212	180	307	332	348	282	260	216	NA	260	NA	170	227	332	270	NA
Blood loss (mL or % TBV)	36%	3373	4100	3300	4900	1200	2642	2955	2561	950	3400	2000	NA	1882	NA	2553	1327	1596	910	NA
F/U (yr)	10.9	1.8	4.6	3.5	Until discharge	5	5.2	1.6	1.4	3.3	4.5	2.3	1	2	3.86	6.9	4	4	3	6.6
MDSQ score at F/U	38.1	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA	35.1	NA	NA	NA	NA	NA

¹This cohort included 20 Duchenne muscular dystrophy patients and 7 patients with spinal muscular atrophy.

C: Colorado; CD: Cotrel-Dubousset; FVC: Forced vital capacity; F/U: Follow-up; G: Galveston technique; H: Harrington; HL: Harrington-Luque; L: Luque sublaminar wires; LL: Lower lumbar; MDSQ: Muscular Dystrophy Spinal Questionnaire; P: Pelvis; PH: Pedicle hooks; PS: Pedicle screws; S: Synergies; SL: Sublaminar instrumentation; SP: Sacropelvis; USS: AO universal spine system; NA: Not available; TBV: Total blood volume; NA: Not available.