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[Surgical options and result analyses in adult degenerative lumbar scoliosis].
Zhonghua Yi Xue Za Zhi. 2009 May 05; 89(17):1166-70.ZY

Abstract

OBJECTIVE

To investigate the clinical and radiographic outcomes for varying degrees of degenerative lumbar scoliosis using different surgical options with a minimal 5-year follow-up.

METHODS

From May 1998 to November 2002, 31 patients with degenerative lumbar scoliosis underwent operations at our hospital. The mean age of 19 females and 12 males was 55.8 years old (range: 45 to 71). All patients were divided into 4 groups: Group A, mild coronal deformity with obvious sagittal deformity, 13 cases; Group B, obvious coronal deformity with mild sagittal deformity; Group C, both significant coronal and sagittal deformities; Group D, both mild coronal and sagittal deformities. Posterior decompression, internal fixation and bone graft fusion were performed in Groups A, B and C. And posterior decompression was performed in Group D. All patients were followed up for at least 5 years. Patients answered the Oswestry low back pain disability questionnaire at pre-operation, and 1 year, 5 year post-operation.

RESULTS

Thirty patients were followed up for the whole process. According to Cobb's angle methods, there was great post-operative improvement for patients with internal fixation (Groups A, B, C) while there was no significant difference for patients with posterior decompression at pre-and post-operation. After surgery, the average Oswestry Disability Index score in the patients with internal fixation (Groups A, B, C) was significantly lower than the preoperative score (25.8 vs 58.0; P < 0.001). However there was statistical difference for patients with internal fixation between 1 year and 5 year postoperatively. No perioperative death or major medical complications occurred. Ten patients had adjacent segment degeneration.

CONCLUSIONS

The surgical aim for adults with a spinal deformity is to achieve a stable, balanced and pain-free spine. Surgical treatments should consist of decompression and fusion with segmental instrumentation to avoid instability and curb progression. Despite the complexity of adult lumbar degenerative scoliosis, it might improve the quality of life for patients by choosing an appropriate operation option on the basis of varying degrees of lumbar deformity.

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Publisher Full Text

Authors+Show Affiliations

Sun ZM
Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China. SZM618@yahoo.com.cn
Zhao D
No affiliation info available
Deng SC
No affiliation info available
Zhao HY
No affiliation info available

MeSH

AgedDecompression, SurgicalFemaleFollow-Up StudiesHumansInternal FixatorsLumbar VertebraeMaleMiddle AgedRetrospective StudiesScoliosisSpinal FusionTreatment Outcome

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

19595079

Citation

Sun, Zhi-ming, et al. "[Surgical Options and Result Analyses in Adult Degenerative Lumbar Scoliosis]." Zhonghua Yi Xue Za Zhi, vol. 89, no. 17, 2009, pp. 1166-70.
Sun ZM, Zhao D, Deng SC, et al. [Surgical options and result analyses in adult degenerative lumbar scoliosis]. Zhonghua Yi Xue Za Zhi. 2009;89(17):1166-70.
Sun, Z. M., Zhao, D., Deng, S. C., & Zhao, H. Y. (2009). [Surgical options and result analyses in adult degenerative lumbar scoliosis]. Zhonghua Yi Xue Za Zhi, 89(17), 1166-70.
Sun ZM, et al. [Surgical Options and Result Analyses in Adult Degenerative Lumbar Scoliosis]. Zhonghua Yi Xue Za Zhi. 2009 May 5;89(17):1166-70. PubMed PMID: 19595079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Surgical options and result analyses in adult degenerative lumbar scoliosis]. AU - Sun,Zhi-ming, AU - Zhao,Dong, AU - Deng,Shu-cai, AU - Zhao,He-yuan, PY - 2009/7/15/entrez PY - 2009/7/15/pubmed PY - 2009/11/11/medline SP - 1166 EP - 70 JF - Zhonghua yi xue za zhi JO - Zhonghua Yi Xue Za Zhi VL - 89 IS - 17 N2 - OBJECTIVE: To investigate the clinical and radiographic outcomes for varying degrees of degenerative lumbar scoliosis using different surgical options with a minimal 5-year follow-up. METHODS: From May 1998 to November 2002, 31 patients with degenerative lumbar scoliosis underwent operations at our hospital. The mean age of 19 females and 12 males was 55.8 years old (range: 45 to 71). All patients were divided into 4 groups: Group A, mild coronal deformity with obvious sagittal deformity, 13 cases; Group B, obvious coronal deformity with mild sagittal deformity; Group C, both significant coronal and sagittal deformities; Group D, both mild coronal and sagittal deformities. Posterior decompression, internal fixation and bone graft fusion were performed in Groups A, B and C. And posterior decompression was performed in Group D. All patients were followed up for at least 5 years. Patients answered the Oswestry low back pain disability questionnaire at pre-operation, and 1 year, 5 year post-operation. RESULTS: Thirty patients were followed up for the whole process. According to Cobb's angle methods, there was great post-operative improvement for patients with internal fixation (Groups A, B, C) while there was no significant difference for patients with posterior decompression at pre-and post-operation. After surgery, the average Oswestry Disability Index score in the patients with internal fixation (Groups A, B, C) was significantly lower than the preoperative score (25.8 vs 58.0; P < 0.001). However there was statistical difference for patients with internal fixation between 1 year and 5 year postoperatively. No perioperative death or major medical complications occurred. Ten patients had adjacent segment degeneration. CONCLUSIONS: The surgical aim for adults with a spinal deformity is to achieve a stable, balanced and pain-free spine. Surgical treatments should consist of decompression and fusion with segmental instrumentation to avoid instability and curb progression. Despite the complexity of adult lumbar degenerative scoliosis, it might improve the quality of life for patients by choosing an appropriate operation option on the basis of varying degrees of lumbar deformity. SN - 0376-2491 UR - https://www.unboundmedicine.com/medline/citation/19595079/[Surgical_options_and_result_analyses_in_adult_degenerative_lumbar_scoliosis]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0376-2491&amp;year=2009&amp;vol=89&amp;issue=17&amp;fpage=1166 DB - PRIME DP - Unbound Medicine ER -