• Anuj V Mehta, Robert Maurer, and G Timothy Reiter.
• Department of Neurosurgery, Penn State Health, Hershey, Pennsylvania, USA.
• World Neurosurg. 2020 Jul 1; 139: 281-285.

BackgroundFacioscapulohumeral muscular dystrophy (FSHD) is a rare condition affecting 1/20,000 persons and the third most common muscular dystrophy condition, with an autosomal dominant pattern of inheritance characterized by progressive muscular weakness primarily involving the face, shoulder girdle, and upper arm. The condition is associated with atrophic musculature of the trunk and core leading to difficulties with gait, posture, and function. FSHD leaves as many as 20% of patients wheelchair-bound and most commonly presents with low back, neck, and shoulder pain.Case DescriptionWe present the case of a patient with FSHD who underwent multiple spinal fusion surgeries without relief in her back pain. Imaging studies serve to highlight the extent of paraspinal muscle atrophy and provides the basis for a discussion on the preoperative factors that may predict patients most likely to benefit from surgery. We then provide a brief review of the literature on the role of paraspinal muscle atrophy in back pain.ConclusionsThis case adds to our understanding of the surgical management of patients with FSHD and patients with atrophic core musculature as a whole.Copyright © 2020 Elsevier Inc. All rights reserved.

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