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KMID : 0388720230300020062
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Journal of Korean Society of Spine Surgery
2023 Volume.30 No. 2 p.62 ~ p.68
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Difficulty Looking Down in Patients with Muscular Dystrophy after Scoliosis Correction: A Preliminary Report
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Hong Seong-Hwa
Chang Bong-Soon
Chang Sam-Yeol
Kang Dong-Ho
Kim Hyoung-Min
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Abstract
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Study Design: Retrospective comparative radiological study.
Objectives: This paper aimed to shed light on the difficulty experienced by patients with muscular dystrophy in looking down at the ground after surgery for spinal deformity correction.
Summary of Literature Review: Neuromuscular scoliosis (NMS), which tends to result in thoracolumbar kyphosis and pelvic imbalance, often occurs in patients with muscular dystrophy. Preceding studies have focused mainly on normalizing NMS curvature, without considering neck motion.
Materials and Methods: This retrospective case series included eight patients who underwent posterior spinal deformity correction surgery for NMS between July 2021 to April 2022. Whole-spine lateral radiography was taken before and after surgery to measure cervical lordosis, thoracic kyphosis, lumbar lordosis, chin-brow vertical angle, T1 slope, C2-C7 sagittal vertical axis (SVA), and C7-S1 SVA.
Additional information regarding patients’ ability to flex their neck sufficiently was also included. Logistic regression was performed to assess neck flexion difficulty with radiographic sagittal parameters.
Results: All patients were able to look down sufficiently preoperatively. However, 75% (n=6) of the patients, who had larger preoperative C7-S1 SVA (p=0.028), displayed significant postoperative difficulty in neck flexion.
Conclusions: Correction of NMS requires special consideration regarding sagittal balance and head position. Preoperative positive sagittal balance is related to postoperative difficulty in neck flexion.
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KEYWORD
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Neuromuscular scoliosis, Muscular dystrophy, Sagittal vertical axis, Spinal deformity correction
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