Miller F, Moseley C F, Koreska J
Department of Orthopaedics, Alfred I. duPont Institute, Wilmington, DE 19899.
Dev Med Child Neurol. 1992 Sep;34(9):775-86. doi: 10.1111/j.1469-8749.1992.tb11516.x.
Sixty-eight patients from a clinical population of 183 patients with Duchenne muscular dystrophy underwent posterior spinal fusion with instrumentation for progressive spinal deformity. Pulmonary complications were the most common postoperative problem, occurring in 17 per cent of the patients. A 35 per cent normal forced vital capacity was a reliable indicator of pulmonary complication risk. The patients with surgically stabilized spines were more comfortable in the later years of life and easier to care for, but deteriorating pulmonary function was not affected by the spinal fusion. The average age at death for the 29 boys who underwent spinal fusion was 18.3 years, which was similar to that of the 58 boys with scoliosis. Factors that improved the patients' quality of life included segmental instrumentation, fusion from T2 to the pelvis, correcting or balancing scoliosis, creating normal sagittal plane alignment and correcting pelvic obliquity.
在183例杜氏肌营养不良症临床患者中，68例因进行性脊柱畸形接受了后路脊柱融合内固定手术。肺部并发症是最常见的术后问题，发生率为17%。用力肺活量为正常水平的35%是肺部并发症风险的可靠指标。脊柱通过手术获得稳定的患者在晚年生活中更舒适，护理也更容易，但肺功能恶化不受脊柱融合的影响。接受脊柱融合手术的29名男孩的平均死亡年龄为18.3岁，这与58名脊柱侧弯男孩的平均死亡年龄相似。改善患者生活质量的因素包括节段性内固定、从T2至骨盆的融合、矫正或平衡脊柱侧弯、建立正常矢状面排列以及矫正骨盆倾斜。
