Surgical management for degenerative lumbar scoliosis

CHANG Yunbing; ZHAN Shiqiang; WANG Yisheng; KE Yuhong; LIU Bin; WANG Qiaoming; ZENG Shixing; YIN Dong; XIAO Dan

doi:10.3969/j.issn.1674-666X.2013.04.006

Abstract：Objective To investigate the individualized surgical treatment of degenerative lumbar scoliosis (DLS), and to evaluate the clinical outcomes of those different surgical techniques. Methods Twenty-seven DLS patients were treated surgically in Guangdong General Hospital from December 2007 to December 2010, and followed up over 24 months. According to clinical symptoms, signs and radiology examination, combined with the evaluation of fundamental diseases, three kinds of surgical procedures were performed including decompression only, decompression with short segmental fixation and fusion, as well as decompression with multilevel correction, fixation and fusion. Postoperative pain relief and function improvement of DLS patients were observed. Results All patients were followed up from 27 to 63 months, with the average of 34.9 months. Scoliotic Cobb angle at 2 years after the surgery was 7.7° ± 0.7° . Preoperative and postoperative VAS score and ODI were 1.7 ± 0.4, 8.4 ± 0.4 and 70 ± 4, 19 ± 4 respectively, the differences between preoperative and postoperative had statistical significance (P <0.05). According to VAS criteria, there were excellent in 7 cases, good in 10 cases, fair in 8 cases and poor in 2 cases, the excellent and good rate was 63% (17/27);According to ODI criteria, there were excellent in 11 cases, good in 12 cases, fair in 2 cases and poor in 2 cases, with the excellent and good rate was 85% (23/27). One patient with serious osteoporosis had fixation loosening, and 2 patients suffered from muscle weakness, and then got complete recovery 3 months after the surgery. Conclusions More attentions should be paid on symptoms rather than deformities in the surgical treatment of DLS. Indications and surgical methods should be selected individually according to different patients.