Postoperative malnutrition in Duchenne muscular dystrophy

Area of Science:

• Neurology
• Orthopedics
• Nutrition

Background:

• Duchenne muscular dystrophy (DMD) can lead to malnutrition and early death, often due to reduced caloric intake.
• While dysphagia is rare in DMD, weight loss is a significant concern, particularly post-surgery.
• Scoliosis is common in DMD, and surgical repair is often necessary.

Purpose of the Study:

• To investigate the association between scoliosis repair surgery and malnutrition in patients with Duchenne muscular dystrophy.
• To identify factors contributing to weight loss following scoliosis surgery in DMD patients.

Main Methods:

• Retrospective chart review of DMD patients who underwent scoliosis repair.
• Comparison of patients experiencing significant weight loss (>5% body weight) with those who gained weight and a non-surgical control group.
• Assessment of self-feeding ability and biceps strength pre- and post-surgery.

Main Results:

• Nine DMD boys lost >5% body weight within 12 months of scoliosis surgery.
• Weight loss was significantly associated with the inability to self-feed post-surgery.
• No change in biceps strength was observed in any surgical group, but weight loss correlated with loss of self-feeding ability.

Conclusions:

• Scoliosis repair in DMD patients can be associated with malnutrition, primarily linked to loss of self-feeding ability.
• Pre- and postoperative management should include comprehensive feeding evaluations.
• Assessment of postural changes is recommended to optimize nutritional support in DMD patients undergoing scoliosis surgery.