Duchenne Muscular Dystrophy, restoring ability to sit straight and comfortably in a wheelchair

Description

This 19-year-old male patient has Duchenne Muscular Dystrophy (DMD). He was having trouble sitting comfortably in his wheelchair because he had developed a progressive pelvic obliquity and scoliosis; his spine was curving and pushing him to the left.

Treatment

Dr. Bridwell performed a posterior spinal fusion with instrumentation. It was a very long fusion: it went from his thoracic spine (the area near the rib cage and shoulder blades) all the way to his sacrum and pelvis. It was necessary to do such a long fusion because it provides more stability to the spine for DMD patients.

Over the years, Dr. Bridwell and his team have used several constructs to achieve this long fusion. They are always bilateral rods from the upper thoracic spine to the sacrum and pelvis with multiple fixation points of either hooks, sublaminar wires, or pedicle screws. For this patient, Dr. Bridwell used sublaminar wires and bilateral instrumentation to the pelvis.

Now, Dr. Bridwell more commonly uses pedicle screws, but as you can see in this case, the sublaminar wire technique works well, too.

Result

After surgery, the patient was able to sit in his wheelchair more comfortably. It is horrible and terrible for a boy with Duchenne’s Muscular Dystrophy to have to spend the last several years of his life without being able to sit up straight. This operation affords them the ability to sit up straight and see the world around them and enjoy life into their teenage years and into young adult years.