Surgical treatment of neck hyperextension in Duchenne muscular dystrophy by posterior interspinous fusion

Sandro Giannini, Cesare Faldini, Stavroula Pagkrati, Gianluca Grandi, Matteo Romagnoli, Luciano Merlini

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN. Seven patients affected by Duchenne muscular dystrophy with neck hyperextension or poor head control in extension have undergone surgery consisting of posterior cervical interspinous fusion. OBJECTIVE. To report the results of surgical treatment of neck hyperextension executed simultaneously with the correction of the thoracolumbar scoliosis. SUMMARY OF BACKGROUND DATA. A severely progressive deformity of the spine in patients affected by DMD can involve also the cervical spine presenting a rigid neck hyperextension or poor head control in extension, forcing the patients to assume awkward compensating postures in order to look straight ahead, worsening significantly their quality of life. METHODS. The procedure consisted of a posterior approach to the cervical spine, correction of the hyperextension by releasing the fibrotic muscles and ligaments, and stabilization with bone grafts driven into the interspinous spaces, to achieve solid fusion. RESULTS. No surgical complications were observed, and fusion was achieved in all patients. The mean angle between C2-C7 decreased from an average of 29.8°(7°-56°) before surgery, to an average of 18.5°(6°-30°) at 1 year of follow-up. Range of motion between C1-C2 was preserved. CONCLUSIONS. Surgical treatment of neck hyperextension in these patients contributes to a better sitting position, to an easier nursing, to a better appearance.

Original languageEnglish
Pages (from-to)1805-1809
Number of pages5
JournalSpine
Volume31
Issue number16
DOIs
Publication statusPublished - Jul 2006

Keywords

  • Cervical spine
  • Duchenne muscular dystrophy
  • Myopathy
  • Neck hyperextension
  • Surgery

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

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