Our Summary

This research paper looked at whether there has been a decrease in surgical treatment for scoliosis (a curvature of the spine) caused by Duchenne muscular dystrophy (DMD) over an 11-year period. DMD is a type of muscular dystrophy that can lead to weak muscles and scoliosis, which has traditionally been treated with surgery. However, in 2004, a study showed that the use of a type of medicine called glucocorticoids could slow the progression of scoliosis in people with DMD.

In this study, researchers used a large database of hospital patients from 2001 to 2012 to find males with DMD who had surgery to treat their scoliosis. They then looked at how many of these surgeries happened in three different time periods: before the 2004 study was published, immediately after it was published, and a few years after it was published.

The researchers found that the rate of these surgeries decreased by 48% over the 11-year period. This decrease was especially noticeable after the 2004 study was published. This suggests that the decrease in surgeries could be due to the use of glucocorticoids to treat scoliosis in people with DMD, as recommended by the 2004 study.

FAQs

  1. What was the main focus of the research paper on scoliosis surgery?
  2. Has there been a decrease in surgical treatments for scoliosis caused by Duchenne muscular dystrophy?
  3. How did the use of glucocorticoids impact the rate of scoliosis surgeries in people with Duchenne muscular dystrophy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scoliosis surgery is to discuss all treatment options available, including non-surgical options such as physical therapy or medication, before making a decision. It’s important to weigh the potential risks and benefits of surgery and to have a thorough understanding of what to expect before, during, and after the procedure. Additionally, maintaining good communication with your healthcare team and following their recommendations for post-operative care can help ensure a successful recovery.

Suitable For

Patients with scoliosis who have not responded to non-surgical treatments such as physical therapy or bracing are typically recommended for surgery. Additionally, patients with severe spinal curves (typically greater than 40-50 degrees) that are progressing rapidly, causing pain, or impacting lung function are also candidates for surgery. Children and adolescents who are still growing and have a spinal curve greater than 45-50 degrees may also be recommended for surgery to prevent further progression of the curve.

In the case of scoliosis caused by conditions such as Duchenne muscular dystrophy, surgery may be recommended if the curve is severe and impacting the patient’s ability to function or causing respiratory problems. However, with advancements in medical treatments such as glucocorticoids, surgery may not always be necessary and can be avoided in some cases.

Ultimately, the decision to undergo scoliosis surgery is based on a variety of factors including the severity of the curve, the patient’s age and growth potential, and the impact of the curve on the patient’s overall health and quality of life. It is important for patients to work closely with their healthcare provider to determine the best treatment plan for their individual situation.

Timeline

Before scoliosis surgery:

  • Patient is diagnosed with scoliosis, usually through a physical exam and imaging tests such as X-rays or MRI
  • Patient may undergo non-surgical treatments such as physical therapy, bracing, or observation to monitor the progression of the curve
  • If the curve worsens or causes symptoms such as pain or difficulty breathing, surgery may be recommended

After scoliosis surgery:

  • Patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for surgery
  • Surgery is performed to straighten and stabilize the spine, often using metal rods, screws, and/or hooks to correct the curvature
  • Recovery typically involves a hospital stay of a few days to a week, followed by physical therapy and rehabilitation to regain strength and mobility
  • Follow-up appointments with the surgeon are scheduled to monitor the healing process and ensure the spine remains stable
  • Over time, the patient may experience improved posture, reduced pain, and increased function, with the goal of preventing further progression of the scoliosis curve.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scoliosis surgery include:

  1. What are the potential risks and complications associated with scoliosis surgery?
  2. What is the expected outcome and recovery time after scoliosis surgery?
  3. Are there alternative treatments to surgery for scoliosis, such as bracing or physical therapy?
  4. How many scoliosis surgeries have you performed, and what is your success rate?
  5. Will I need physical therapy or rehabilitation after surgery?
  6. How long will I need to stay in the hospital after surgery?
  7. Will I need to wear a brace or use any special equipment after surgery?
  8. How will scoliosis surgery affect my daily activities and quality of life?
  9. Are there any long-term effects or complications I should be aware of after scoliosis surgery?
  10. Can you provide me with any resources or support groups for individuals who have undergone scoliosis surgery?

Reference

Authors: Raudenbush BL, Thirukumaran CP, Li Y, Sanders JO, Rubery PT, Mesfin A. Journal: Spine (Phila Pa 1976). 2016 Sep;41(17):E1030-E1038. doi: 10.1097/BRS.0000000000001534. PMID: 26926354