[Treatment of degenerative lumbar scoliosis via posterior decompression and fusion with internal fixation].

ABSTRACT

OBJECTIVE: To explore the pathogenic mechanism, operative techniques and therapeutic efficacy of lumbar degenerative scoliosis. METHODS: A retrospective analysis was performed for 32 patients (14 males and 18 females with a mean age of 67.4 years old) with degenerative lumbar scoliosis undergoing posterior decompression and fusion with pedicle screw system from January 2007 to March 2010. The post-operative outcomes were radiologically evaluated with Oswestry disability index (ODI), Cobb' angle and lumbar lordosis angle. RESULTS: All patients received a mean follow-up of 28.5 months (range 12 - 50). All lumbar joints achieved bony fusion at Month 6 post-operation. No complications occurred due to instrumentation. There was no pseudoarthrosis. The significant differences of ODI existed between pre-operation and post-operation [(60 ± 11)% vs (21 ± 6)%, P < 0.01], Cobb' angle [(28 ± 9)° vs (13 ± 5)°, P < 0.01] and lumbar lordosis angle [(41 ± 12)° vs (20 ± 10)°, P < 0.01]. CONCLUSION: Individualized operations should be performed for degenerative lumbar scoliosis patients. Proper lumbar decompression and the reconstruction of coronal and sagittal balances may relieve symptoms and improve the quality of life.