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Surgery for scoliosis in Duchenne muscular dystrophy

2007; Cochrane; Linguagem: Inglês

10.1002/14651858.cd005375.pub2

1469-493X

Daniel KL Cheuk, Virginia Wong, Elizabeth Wraige, Peter Baxter, Ashley Cole, Tracy N'Diaye, Varaidzo Mayowe,

Prosthetics and Rehabilitation Robotics

Background Scoliosis in people with Duchenne muscular dystrophy is usually progressive and treated with surgery. However, it is unclear whether the existing evidence is sufficiently scientifically rigorous to support a recommendation for spinal surgery for most people with Duchenne muscular dystrophy and scoliosis. This is an updated review and an updated search was undertaken in which no new studies were found. Objectives The objectives of this systematic review were to determine the effectiveness and safety of spinal surgery in people with Duchenne muscular dystrophy with scoliosis. We intended to test whether spinal surgery is effective in increasing survival, improving respiratory function, improving quality of life and overall functioning; and whether spinal surgery is associated with severe adverse effects. Search methods We searched the specialized registers of the Cochrane Neuromuscular Disease Group (July 2010) and Cochrane Back Group (August 2010), MEDLINE (1966 to July 2010), EMBASE (1947 to July 2010), Cochrane Central Register of Controlled Trials (CENTRAL) (July 2010), CINAHL (1982 to July 2010), Proquest Dissertation and Thesis Database (1980 to August 2010), and the National Institute of Health Clinical Trials Database (August 2010). No language restrictions were imposed. Selection criteria We planned to include controlled clinical trials using random or quasi‐random allocation of treatment evaluating all forms of spinal surgery for scoliosis in people with Duchenne muscular dystrophy in the review. The control interventions would have been no treatment, non‐operative treatment, or a different form of spinal surgery. Data collection and analysis Two authors examined the search results and evaluated the study characteristics against inclusion criteria to decide which ones would be included in the review. Main results On electronic search, 45 studies were relevant but none met the inclusion criteria for the review, because they were not clinical trials but prospective or retrospective reviews of case series. Authors' conclusions Since there were no randomized controlled clinical trials available to evaluate the effectiveness of scoliosis surgery in people with Duchenne muscular dystrophy, no evidence‐based recommendation can be made for clinical practice. People with scoliosis should be informed about the uncertainty of benefits and potential risks of surgery for scoliosis. Randomized controlled trials are needed to investigate the effectiveness of scoliosis surgery, in terms of quality of life, functional status, respiratory function and life expectancy.