Personal Point of ViewScoliosis in Duchenne muscular dystrophy (DMD)

Scoliosis is a frequent complication in the non-ambulant patient with Duchenne muscular dystrophy (DMD). Weakness of the paraspinal muscles leads to trunk and body positional changes facilitating the development of a progressive collapsing scoliosis which inevitably interferes with comfortable sitting and may exacerbate deteriorating respiratory function. The recommended international standard of care for management of DMD includes strategies to prolong ambulation which may delay the onset of scoliosis. In the non-ambulant child there should be regular monitoring for scoliosis and, when present, surgical treatment should undertaken at an early stage. Careful multi-disciplinary pre-operative assessment and peri-operative care are essential.