Comparison of functional prognosis between surgical and non-surgical scoliosis BACKGROUND: Most of the current studies on DMD scoliosis have focused on technical and imaging indicators, however, functional status is a more important factor in determining the treatment strategy for DMD. The purpose of this study was to compare the prognostic pulmonary function, imaging prognosis, and functional recovery between surgical and non-surgical treatment of patients with DMD scoliosis using a validated questionnaire. METHODS: In this study 66 patients with DMD scoliosis (40 surgically treated and 26 non-surgically treated) were followed up for a minimum of 2 years. Exertional spirometry, imaging parameters (Cobb angle, kyphosis, and pelvic tilt), and functional status (by modified Rancho scale, unassisted muscle strength measurement) were measured preoperatively and at the follow-up endpoint, respectively, according to a comparison of modified Rancho scale and handed muscle strength measurement. In addition, the myotonic spine assessment questionnaire was used at the endpoint of follow-up. RESULTS: At the initial assessment (pre-surgery), there were no differences between the two groups in pulmonary function, functional scores, and imaging parameters (except for kyphosis). At the follow-up endpoint, patients in the surgical group showed a significant improvement in imaging parameters compared to non-surgical patients. The mean scores (and standard deviations) on unassisted muscle strength measurements were not significantly different between the surgical and non-surgical groups. There was also no difference between the two groups in the scores on the modified Rancho scale. The mean MDSQ (Myotonic Dystrophy Spine Assessment Questionnaire) score was higher in the surgical group than in the non-surgical group. Exertional spirometry was decreasing in both groups, but at a significantly slower rate in the surgical group (268 ± 361 ml) than in the non-surgical group (536 ± 323 ml) (p = 0.035). CONCLUSION: Surgical treatment of patients with DMD scoliosis significantly improves the functional prognosis of patients and slows the rate of decline in exertional lung volume.