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EVALUATION OF SINGLE ROD FUSION TECHNIQUE FOR SCOLIOSIS SECONDARY TO DUCHENNE MUSCULAR DYSTROPHY.



Abstract

Introduction: Duchenne’s Muscular Dystrophy (DMD) is a progressive sex linked recessive disease, predominantly involving skeletal muscle. Scoliosis is almost universal in patients with DMD. Surgical stabilization carries a significant risks and complications with peroperative mortality of < 6%. Cardiopulmonary complications along with severe intraoperative blood loss requiring massive blood transfusion are the major cause of morbidity

Aim: To evaluate the efficacy of single rod fusion technique in reducing the peroperative and post operative complications especially blood loss, duration of surgery and progression of curve

Material & Methods: Retrospective review – 14 patients with scoliosis secondary to DMD with an average age of 14.5 years (range, 11–17) underwent single rod fusion technique using Isola rod system and pelvic was not included in fixation. Blood loss was measured directly from the peroperative suction and post operative drainage, indirectly by weighing the swabs. Vapour free hypotensive anesthesia was used in all case. Progression of curve was monitored over a period of five years.

Results: The mean operative time was 110 min (range, 80 – 180). The average blood loss was 1.6L (range, 0.7 – 5). The mean follow up was 32 months (range, 4 – 60). There was no progression noticed in the curve on follow up. Two patients develop complications, one had loosening & migration of the rod, required revision and superficial wound infection treated with intravenous antibiotics.

Conclusion: In our experience, single rod stabilization is a safe and quick method of stabilizing the spine in DMD with less blood loss and complications compared to traditional methods.

For information please contact BSCOS at the Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN