Scoliosis-correcting surgery may prolong survival in patients with Duchenne muscular dystrophy (DMD), according to a recently published study in the Archives of Orthopedic and Trauma Surgery.
Understanding scoliosis and Duchenne
Over 90% of patients with DMD also suffer from scoliosis, a condition in which the spine curves sideways. Mild cases often go unnoticed, but severe cases are associated with postural abnormalities, back pain, and, in extreme cases, breathing difficulties.
Surgery has been associated with clear benefits. However, many consider it too invasive and risky for patients with DMD. In recent decades, several therapeutic alternatives to surgery, such as corticosteroid therapy and nocturnal ventilation, have also shown positive results. Therefore, the use of scoliosis-correcting surgery for patients with DMD remains controversial.
“We aimed to provide guidance for the selection of appropriate clinical treatment,” the authors wrote.
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Analyzing the research
To shed light on the issue, the authors conducted an extensive literature review using several medical databases to evaluate the combined results from various studies on the topic.
They identified six papers, including a total of 498 patients, that met their inclusion criteria. All six studies compared the outcomes of patients who underwent surgery with those who did not. The results showed that patients in the surgical group had overall better survival than those in the non-surgical group.
The authors reported 86 cases in which surgery led to complications, representing a higher complication rate than that observed in the non-surgical group.
Conclusions
The authors emphasized that their findings support the use of scoliosis-corrective surgery in patients with DMD. Although conservative treatments can slow the progression of scoliosis, surgery addresses the underlying structural issue.
They concluded that despite the higher complication rate, the benefits of surgery —particularly regarding respiratory function and survival — outweigh the potential risks.
“Notably, scoliosis-correction surgery improves patient survival,” the authors concluded, though they noted “non-surgical treatment has the advantage of a lower rate of complications.”
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