The Patterns of Spinal Deformity in Duchenne Muscular Dystrophy

ABSTRACT

OBJECTIVE: To investigate the relationships between scoliosis and kyphotic or lordotic posture in Duchenne muscular dystrophy (DMD) patients, this study explored the factors influencing the development of spinal deformity. METHOD: Twenty five DMD patients with scoliosis were conducted to roentgenographic study to obtain Cobb's angle. In addition, rotation grade of the spine, as well as the degree of kyphotic and lordotic postures were obtained using the Moe pedicle method, kyphotic index and lumbo sacral angle respectively. The data were assessed for the correlations among spinal deformities as well as the evaluation of functional state. After comprehensive rehabilitation programs for six months including scoliosis correction exercise, breathing exercise and thoracolumbosacral spinal orthosis, the effects of spinal deformity and pulmonary function were analyzed. An age-matched control group of 15 male patients with scoliosis were analyzed and compared with the experimental group. RESULTS: In the experimental group, the scoliosis angles were negatively correlated with kyphotic index (r= 0.80, p<0.01). In the control group, no correlations of statistical significance were detected among different types of spinal deformity. In addition, the rotation grade was found to be positively correlated with the scoliosis angle in the experimental group (r=0.89, p<0.01). Furthermore, the larger the scoliosis angle, the patients functional state was found to be poorer (r=0.56, p<0.01). CONCLUSION: In DMD patients, a strong correlation was found between the scoliosis and kyphotic posture. For the prevention of kyphotic posture, further study on the relevant therapeutic approach would be needed.