Impact of Steroids on Surgical Experiences of Patients With Duchenne Muscular Dystrophy

We studied surgical experiences within a regional cohort of patients with Duchenne muscular dystrophy, managed at a single center. Records of all patients with confirmed Duchenne muscular dystrophy who were born after 1962 were reviewed from birth until they reached study endpoints: scoliosis surgery, Achilles tendon lengthening, cataract surgery, loss to follow-up, or final follow-up point in 2009. A survival analysis was used to account for the variable follow-up duration within this cohort. By the end of the study period, 28/80 (35.0%) of boys with Duchenne muscular dystrophy had undergone spinal surgery, 22/80 (27.5%) had experienced Achilles tendon lengthening, and 6/80 (7.5%) had had cataracts removed. Moreover, 56.8% of this cohort received steroid therapy (prednisone or deflazacort; 95% confidence interval, 43.3-68.8%). Boys who had received steroid therapy were significantly less likely to undergo spinal surgery (P = 0.001), but were subsequently more likely to require cataract surgery (P = 0.005). Achilles tendon lengthening did not seem related to medication exposure. The treatment of patients with Duchenne muscular dystrophy with steroids significantly modified their surgical experience. (C) 2010 by Elsevier Inc. All rights reserved.