Surgical treatment of degenerative lumbar scoliosis
WU Zenghui
MA Xiangyang
ZHANG Kai
AI Fuzhi
WANG Zhiyun
WANG Jianhua
XIA Hong
Abstract：Objective To evaluate the clinical efficacy and the complications in the surgical treatment for patients with degenerative lumbar scoliosis (DLS). Methods A total of 62 DLS patients were treated using procedures of selective spinal canal decompression + pedicle screw fixation + Cage interbody fusion and correction in Guangzhou General Hospital of Guangzhou Military Command during January 2003 to January 2013. Estimate blood loss, postoperative pain relief in lower extremity and recovery of muscle strength were observed, lumbar scoliosis, lordosis and interbody fusion were examined, and visual analogue scale (VAS) scores, signs and complications were recorded. Results In 62 patients, 61 patients completed surgery smoothly, while 1 patient underwent reoperation 3 d after the first surgery due to intraoperative hypopiesia. Estimate blood loss was 530-2 800 mL with the average of 920 mL. Perioperative complications occurred in 7 cases (11%), including brain infarction in 2 cases, cerebrospinal fluid leakage in 2 cases, muscle strength decreased in unilateral lower extremity in 3 cases. Forty-one patients were followed up from 0.5 to 10.0 years (average, 5.6 years). During the follow-up, 6 patients had long-term complications (15%, 6/41), including screw loosening in 3 cases who performed the following revision operation, and vertebral compression fractures in 3 patients who underwent the following vertebroplasty. VAS scores decreased from the average of 7.4 (6.1-8.5) at preoperation to the average of 2.8(1.6-4.3) at postopoeration. Preoperative and postoperative lumbar scoliotic, lordotic Cobb angles were 30.5° (20°-40°) and 8.6° (3°-25°), 5.6° (-8°-13°) and 31.6° (25°-46°) respectively. X-ray showed good fusion in all cases. There was no intervetebral height loss, also no Cage collapse or dislocation occurred. Conclusions Procedures of selective spinal canal decompression + pedicle screw fixation + lumbar interbody fusion and correction can relieve back and leg pain effectively, rebuild and maintain the lumbar lodorsis, and correct scoliosis, but the incidence of surgical complications is relative high.
Keywords：Degenerative diseasesLumbar vertebraeScoliosisSpinal fusionDecompressionsurgicalInternal fixatorsPostoperative complications
Publication Date：2013-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 221-225 )