INTRODUCTION: Degenerative lumbar scoliosis (DLS) is commonly present in older adult patients with spinal pain. The extent of fusion for degenerative lumbar scoliosis has not yet been determined. The purpose of this study is to analyse the surgical results of short segmental fusion after selective decompression for degenerative lumbar scoliosis.
METHODS: 42 patients with DLS complaining of lower extremities pain treated surgically in our hospital from January 2004 to June 2007 were reviewed. 15 males and 27 femals, averaged 65.6 years old, were included. The follow‐up time ranged from 1 to 3.5 years postoperatively. The selective posterior decompression and short segmental fusion with pedicle screws were employed, and fusion levels were limited within scoliosis curves. The fusion level, blood loss, operation time and perioperative comorbidity and complication were recorded. Preoperative and postoperative cobb angles, lumbar lordotic angles, VAS and ODI were evaluated, and statistical difference was analysed.
RESULTS: The difference between preoperative and follow‐up VAS score is statistically significant, and statistical difference also found in ODI score. The statistical difference was not found between preoperative and follow‐up cobb angles, and it was not found in lordotic angle, either. Early complication occurred to 23 percent of patients, including urinary infection, ileus et al. No major complications happened during perioperative period, and no screw failures, compression fracture occurred during the follow‐up period.
DISCUSSION: Selective posterior decompression and short segmental fusion is an effective way to treat degenerative lumbar scoliosis with main complaint of lower limbs discomforts. The surgical results are related with lumbar canal and foraminal decompression, but not related with change of cobb angles. The surgical treatment can reduce surgical injuries and leave more mobile levels for degenerated lumbar spine in old patients. Local stability was also preserved in this procedure.