TY - JOUR
T1 - Difficulty Looking Down in Patients with Muscular Dystrophy after Scoliosis Correction
T2 - A Preliminary Report
AU - Hong, Seong Hwa
AU - Chang, Bong Soon
AU - Chang, Sam Yeol
AU - Kang, Dong Ho
AU - Kim, Hyoungmin
N1 - Publisher Copyright:
© 2023 Korean Society of Spine Surgery.
PY - 2023/6
Y1 - 2023/6
N2 - 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.
AB - 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.
KW - Muscular dystrophy
KW - Neuromuscular scoliosis
KW - Sagittal vertical axis
KW - Spinal deformity correction
UR - http://www.scopus.com/inward/record.url?scp=85181919208&partnerID=8YFLogxK
U2 - 10.4184/jkss.2023.30.2.62
DO - 10.4184/jkss.2023.30.2.62
M3 - Article
AN - SCOPUS:85181919208
SN - 2093-4378
VL - 30
SP - 62
EP - 68
JO - Journal of Korean Society of Spine Surgery
JF - Journal of Korean Society of Spine Surgery
IS - 2
ER -