Key result
Spinal fusion resulted in a decline in gross motor function and increased use of upper extremity aids in weaker patients, while stronger patients maintained their activities.
Why the study?
How does spinal fusion affect functional activities in patients with spinal muscular atrophy?
Cohort (n=40)
How does spinal fusion affect functional activities in patients with spinal muscular atrophy?
Spinal fusion in weaker patients with spinal muscular atrophy may lead to a decline in gross motor function due to loss of spinal flexibility.
Spinal fusion may impair function in weaker SMA patients; leaves open optimal selection and prospective trials by baseline strength.
Spinal muscular atrophy patients present with weakness, greater in the proximal muscles, leading to scoliosis and limited upper extremity function. The purpose of this study is to identify unique aspects of these patients and to understand how spinal fusion affects their function. Forty patients underwent Harrington or Luque rod instrumentation with functional evaluations preoperatively and 2 and 5 years postoperatively. Biomechanical assessment of function is important. Flexibility of the spine is functionally advantageous because distal strength is used to align weaker proximal segments. Postoperatively, lack of spinal flexibility resulted in a decline in gross motor function and increased use of UE aids due to a change in the trunk position in the weaker patients. The stronger patients' activities were maintained. Earlier mobilization in patients with Luque procedures did not improve postoperative function.
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Furumasu et al. (1989) conducted a cohort in Spinal muscular atrophy (n=40). Spinal fusion (Harrington or Luque rod instrumentation) was evaluated on Gross motor function and use of upper extremity aids. Spinal fusion resulted in a decline in gross motor function and increased use of upper extremity aids in weaker patients, while stronger patients maintained their activities.
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