Key result
There was no clinically significant difference in operative and postoperative outcomes between patients with pre-operative forced vital capacity >30% and ≤30% undergoing corrective spinal surgery.
Why the study?
Does a pre-operative forced vital capacity ≤ 30% predicted worsen operative and postoperative outcomes in patients with Duchenne's muscular dystrophy undergoing corrective spinal surgery?
Cohort (n=45)
No
Does a pre-operative forced vital capacity ≤ 30% predicted worsen operative and postoperative outcomes in patients with Duchenne's muscular dystrophy undergoing corrective spinal surgery?
Patients with Duchenne's muscular dystrophy and a pre-operative forced vital capacity ≤ 30% predicted can safely undergo corrective spinal surgery without an unacceptably high incidence of postoperative complications.
Answers are grounded in this paper and cite their sources.
Supports expanding surgical eligibility to Duchenne patients with FVC ≤30%; hypothesis-generating and requires prospective validation.
The majority of patients with Duchenne's muscular dystrophy require corrective spinal surgery for scoliosis to maintain seated balance and to slow the progression of respiratory compromise, thereby facilitating nursing and enhancing their quality of life. Traditionally patients with a pre-operative forced vital capacity (PFVC) of 30% or below predicted have been denied this surgery as it was thought that the incidence of postoperative complications was unacceptably high. We present data collected prospectively from 45 consecutive operations undertaken in our unit. These cases indicate that there is no clinically significant difference in operative and postoperative outcomes between patients with PFVC > 30% and < or =30%. However, the routine postoperative use of mask ventilation to facilitate early tracheal extubation is vital.
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Harper et al. (2004) conducted a cohort in Duchenne's muscular dystrophy requiring corrective spinal surgery for scoliosis (n=45). Pre-operative forced vital capacity (PFVC) > 30% vs. PFVC ≤ 30% was evaluated on Operative and postoperative outcomes. There was no clinically significant difference in operative and postoperative outcomes between patients with pre-operative forced vital capacity >30% and ≤30% undergoing corrective spinal surgery.
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