Analysis of surgical effects and related complications for patients with degenerative scoliosis

SHEN Jianxiong; LIANG Jinqian; XUE Xuhong

doi:10.3969/j.issn.1674-666X.2013.04.007

Abstract：Objective To explore clinical effects and analyze the perioperative and long-term complications associated with surgical treatment for adult de-novo degenerative scoliosis (DDS). Methods Clinical data of 320 DDS patients underwent operations in Peking Union Medical College Hospital from August 2000 to August 2011 were retrospectively reviewed. Clinical efficacy was evaluated by Oswestry disability index (ODI) and modified Prolo scoring, degree of satisfaction of patients was recorded, and the complications related to the operations were observed. Results All patients were followed up from 1 to 8 years (average, 4.2 years). At the final follow-up, average ODI score was 38.2 (25-48), the excellent and good rate of modified Prolo scoring was 80.9%, degree of satisfaction of patients was 80.9%. Complications associated with surgical treatment occurred in 17 patients (5.3%), including perioperative complications (poor location of pedicle screws in 6 cases, stroke in 1 case, cerebrospinal fluid leakage in 1 case and poor wound healing in 3 cases) and long-term complications (internal fixation loosening in 2 cases and adjacent segment degeneration in 4 cases). Conclusions The prevalence of complications associated with surgical treatment for adult DDS is relatively high because most of DDS patients were elderly, and there existed segmental rotatory deformity in vertebral bodies. So it is quite important for the surgeons to comprehensively analyze the neurological signs, imaging data and clinical symptoms before the surgry, so as to choose appropriate surgical program to prevent surgery-related complications and get satisfied effects.