The operative treatment of scoliosis in Duchenne muscular dystrophy.

The results of segmental spinal stabilization and fusion in nine patients with Duchenne muscular dystrophy are reviewed. The average follow-up time was 3.2 years. Vital capacities averaged 46% (range, 20% to 70%), and there were minimal pulmonary complications. Operative time and blood loss decreased when the spinal fixation method was changed from sublaminar to intraspinous wiring. Segmental wiring anchored through the spinous processes also maintained reduction and distraction until fusion occurred; we recommend this technique. The use of allogenic bone grafts to supplement the autogenous bone graft allowed for extensive fusion; we recommend this technique as well. Furthermore, fusion to the sacrum to prevent further pelvic obliquity should be indicated in all patients who develop scoliosis.