Spinal fusion in patients with Duchenne's muscular dystrophy and a low forced vital capacity

Eur Spine J. 2003 Oct;12(5):507-12. doi: 10.1007/s00586-003-0545-8. Epub 2003 May 14.


Traditionally, spinal fusion has been denied to patients with scoliosis secondary to Duchenne's muscular dystrophy (DMD) when their forced vital capacity (FVC) is less than 30-40% of predicted values (PFVC). The reasons for this decision are a theoretically increased risk of adverse events from a prolonged anaesthetic and extensive surgery. This paper presents a retrospective analysis of 30 patients with DMD scoliosis who underwent posterior spinal fusion at the Royal National Orthopaedic Hospital. Two subgroups of patients were compared: those with more than 30% PFVC (17 patients) and those with less than 30% PVFC (13 patients). One patient in each group required a temporary tracheotomy and there were nine complications in total. The post-operative stay for patients in each group was similar (24 days in the >30% group, 20 days in the <30% group) and the complication rate was comparable with other published series. We conclude that spinal fusion can be offered to patients with DMD even in the presence of a low FVC.

MeSH terms

  • Adolescent
  • Adult
  • Anesthetics, General / adverse effects
  • Child
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Muscular Dystrophy, Duchenne / complications*
  • Patient Selection
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control
  • Respiratory Insufficiency / etiology*
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / surgery*
  • Retrospective Studies
  • Risk Factors
  • Scoliosis / complications*
  • Scoliosis / physiopathology
  • Scoliosis / surgery*
  • Spinal Fusion / adverse effects
  • Spinal Fusion / standards*
  • Treatment Outcome
  • Vital Capacity / physiology


  • Anesthetics, General