Clinical efficacy of selective decompression and fusion with robot-assisted internal fixation in the treatment of degenerative scoliosis

YUAN Ning; ZHAO Jingwei; HE Da; LIU Bo; MA Tengfei

doi:10.3969/j.issn.1002-266X.2025.05.001

Abstract：Objective To evaluate the clinical effect of selective decompression and fusion with robot-assisted inter-nal fixation in the treatment of adult degenerative scoliosis(ADS).Methods Seventy-eight patients with ADS undergo-ing fusion and decompression with robot-assisted internal fixation were retrospectively analyzed.These patients were divid-ed into two cohorts:Group 1(n=41)receiving selective fusion and decompression,and Group 2(n=37)undergoing full-curve fusion and decompression.Intraoperative parameters(the number of fused vertebrae,operative time,and blood loss)and clinical outcomes were compared.The therapeutic effects before and 6 months after operation was assessed by Cobb angle measurement,Roland-Morris Disability Questionnaire(RMDQ),Visual Analog Scale(VAS),Oswestry Dis-ability Index(ODI),and Japanese Orthopaedic Association(JOA)score.Postoperative complications were documented.Results Compared with Group 2,Group 1 demonstrated significantly fewer fused vertebrae,reduced operative time,and lower intraoperative blood loss(all P<0.05).Both groups exhibited postoperative Cobb angle reduction in comparison with the preoperative values(both P<0.05);however,Group 1 showed a larger residual Cobb angle and smaller angular correc-tion than Group 2(both P<0.05).At 6-month follow-up,both groups showed significant improvements in VAS,RMDQ,ODI,and JOA scores compared to the baseline(all P<0.05).Group 1 had lower JOA scores than Group 2(all P<0.05).No significant differences were found in the complications between these two groups(all P>0.05).Conclusion Selective fusion and decompression with robot-assisted internal fixation is more effective in the treatment of ADS,and it can effec-tively improve clinical symptoms.