A 5-year-old male presents for walking abnormalities. His parents observe that he is walking on his toes and his calves have become larger over the past 6 months. His serum creatine phosphokinase (CPK) level is 100 times the normal value. DNA testing confirms Duchenne muscular dystrophy (DMD). Further workup reveals hyperlordosis and scoliosis with a curve measuring 20°. Which of the following categories of medications is effective for preventing scoliosis curve progression?

• • Bisphosphonates
  Bisphosphonates inhibit osteoclasts and are the first-line of treatment for patients with osteoporosis.

 

• Antibiotics

Antibiotics are not used in treatment of patients with patients with neuromuscular scoliosis.

 

 

• Botulinum toxin

Botulinum toxin injections are used for a variety of spastic neuromuscular disorders, but not for treatment of neuromuscular scoliosis.

 

 

• Corticosteroids

In patients with early DMD, corticosteroid therapy has been shown to stabilize muscle strength and should be initiated to maintain ambulatory capacity and prevent curve progression.