Comparison of surgical and non-surgical treatment for scoliosis in Duchenne muscular dystrophy: a systematic review and meta-analysis.

INTRODUCTION

Duchenne muscular dystrophy (DMD) is a neuromuscular disease caused by dystrophin gene mutations, which not only causes severe physical and psychological damage to the patient but also imposes a considerable economic burden on society. However, whether to aggressively surgical treatment for progressive scoliosis of DMD remains a conundrum. Therefore, we aimed to systematically evaluate the efficacy and prognosis of surgical treatment for DMD-associated scoliosis.

MATERIALS AND

METHODS

PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure database, Wanfang database, China Science and Technology Journal Database, and China Biomedical Literature Database were searched for literature from the time of database creation until November 2022. The inclusion parameters were as follows: number of survivors, frequency of complications, preoperative, postoperative, and final follow-up Cobb's angles. Data were analyzed using RevMan 5.4.1 and Stata 12.0.

RESULTS

Six studies were analyzed. Survival rates were higher [OR = 3.83, 95% CI (1.91, 7.66), p = 0.0001] and Cobb's angle improved [SMD, 1.79, 95% CI (150, 2.07), p < 0.00001] in the surgical group than in the non-surgical group. The non-surgical group had a lower complication rate than the surgical group did [OR = 8.75, 95% CI (1.02,75.08), p = 0.048].

CONCLUSIONS

Notably, scoliosis-correction surgery improves patient survival. Besides, scoliosis-correction surgery provides patients with more stable Cobb angle. As expected, non-surgical treatment has the advantage of reducing the occurrence of complications.