Spinal fusion in patients with Duchenne's muscular dystrophy and a low forced vital capacity
Spinal fusion in patients with Duchenne's muscular dystrophy and a low forced vital capacity
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DOI：
10.1007/s00586-003-0545-8
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发表时间：
2003-10-01
影响因子：
2.8
通讯作者：
Lehovsky, J
中科院分区：
文献类型：
--
作者：
Marsh, A;Edge, G;Lehovsky, J
传统上，当强迫肺活量（FVC）低于预测值（PFVC）的30-40%时，杜氏肌营养不良（DMD）继发脊柱侧凸患者拒绝脊柱融合。这一决定的原因是，从理论上讲，长期麻醉和广泛手术的不良事件风险增加。本文回顾性分析了在皇家国立骨科医院接受后路脊柱融合术治疗的30例DMD脊柱侧凸患者。比较两个亚组患者：PVFC超过30%的患者（17例）和PVFC低于30%的患者（13例）。两组各有1例患者需要临时气管切开术，共发生9例并发症。两组患者术后住院时间相似（>30%组24天，>30%组20天）
Traditionally, spinal fusion has been denied to patients with scoliosis secondary to Duchenne's muscular dystrophy (DMD) when their forced vital capacity (FVC) is less than 30-40% of predicted values (PFVC). The reasons for this decision are a theoretically increased risk of adverse events from a prolonged anaesthetic and extensive surgery. This paper presents a retrospective analysis of 30 patients with DMD scoliosis who underwent posterior spinal fusion at the Royal National Orthopaedic Hospital. Two subgroups of patients were compared: those with more than 30% PFVC (17 patients) and those with less than 30% PVFC (13 patients). One patient in each group required a temporary tracheotomy and there were nine complications in total. The post-operative stay for patients in each group was similar (24 days in the >30% group, 20 days in the