Treatment of Spine Deformity in Neuromuscular Diseases
| Autor: | Rolando Figueroa Roberto, Craig M. McDonald, Munish C. Gupta, Sukanta Maitra |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Braces Neuromuscular disease business.industry Rehabilitation Cardiomyopathy Arthrodesis Cosmesis Physical Therapy Sports Therapy and Rehabilitation Neuromuscular Diseases Spinal muscular atrophy Orthotics medicine.disease Natural history of disease Patient Positioning Surgery Pulmonary function testing Radiography Physical medicine and rehabilitation Scoliosis medicine Humans Restrictive lung disease business |
| Zdroj: | Physical Medicine and Rehabilitation Clinics of North America. 23:869-883 |
| ISSN: | 1047-9651 |
| DOI: | 10.1016/j.pmr.2012.08.009 |
| Popis: | Spinal deformity adversely affects the quality of life of patients with progressive hereditary neuromuscular diseases (NMDs). While the impact of spinal arthrodesis on pulmonary function remains controversial (the disease pathogenesis continues to affect chest wall muscles and diaphragm), there can be no doubt that failure to aggressively treat spinal deformity in progressive NMD can have profound negative consequences on sitting balance, pelvic obliquity, ability to sit comfortably in a wheelchair, cosmesis, and quality of life. There are emerging data that improvements in disease management in Duchenne muscular dystrophy (DMD) including treatment with corticosteroids, surgical management of spine deformity, noninvasive ventilation, and more effective treatment of cardiomyopathy have led to improved function and survival in DMD and a changing natural history of disease. Spinal arthrodesis with internal instrumentation is the only effective treatment, but optimally is deferred to the second decade so that anterior approaches are avoided. Spinal orthotics may be used in younger patients to provide postural support and more balanced sitting, but spinal orthotics generally do not affect the natural history of spinal deformity in NMD conditions. Surgical management of the spinal deformity often requires a multidisciplinary approach beginning in the preoperative surgical planning period owing to concomitant restrictive lung disease and cardiomyopathy in selected NMD conditions. |
| Databáze: | OpenAIRE |
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