Indications of different surgical options for degenerative lumbar scoliosis

WANG Hua-dong; WU Wen-wen; LI li; GUO Ji-dong; ZHANG Yu-peng; HOU Shu-xun

doi:10.3969/j.issn.2095-252X.2015.03.06

Abstract：Objective To study the surgical indications of different treatment options for degenerative lumbar scoliosis. Methods A total of 57 patients with degenerative lumbar scoliosis, whose mean age was 59.3 years old ( range:51-78 years ) and mean course was 7.1 years ( range:2-15 years ), underwent different surgical treatment according to their different clinical and radiological manifestations. In group A, 27 patients received multilevel decompression and long segmental pedical screw fixation with correction and posterolateral fusion. Multilevel decompression and short segmental pedical screw ifxation with interbody fusion but without correction were performed on 24 patients in group B. In group C, only multilevel decompression was carried out in 6 patients. All the patients could ambulate at 1-2 weeks after the operation with brace which should be worn for 3-6 months. Results The mean follow-up time was 36.7 months ( range:26-65 months ). The mean correction rate of Cobb’s angle was 73%( range:59%-85%). The operation time and blood loss were ( 150.0±25.2 ) min and ( 450.0±55.3 ) ml in group A, which were larger than ( 92.0±7.5 ) min and ( 205.0±16.5 ) ml in group B and ( 52.0±5.5 ) min and ( 106.0±19.6 ) ml in group C, and the differences between group A and B and group A and C were statistically signiifcant. Effective pain relief and functional improvement had been obtained in all the 3 groups, with no statistically signiifcant differences in lumbar pain Visual Analogue Scale ( VAS ) and Oswestry disability index ( ODI ). Conclusions It is the key to choose the best treatment options according to different surgical indications in order to increase the clinical results in the treatment of degenerative lumbar scoliosis.