Classification and Treatment of Degenerative Lumbar Spinal Deformity

Abstract

Study Design: A retrospective study Objective: To categorize and analyze clinical results of degenerative lumbar deformity patients according to the degree of scoliosis and kyphosis. Summary and Literature Review: A degenerative spinal deformity is classified into a coronal and sagittal deformity. There are some reports about treatment according to each classification but the classification is sometimes inappropriate and the treatment can vary. Materials and Methods: From June 1998 to June 2003, 79 patients, who were diagnosed with a degenerative lumbar deformity and underwent conservative or operative treatment, were studied retrospectively. Group I had scoliosis ranging from 10 to 20。, and group II had scoliosis �20。Each group was subdivided into A, B, and C according to the lordosis, group A �30。, group B between 20 to 30。, and group C �20。. Scoliosis and lordosis were measured from the radiographs and the clinical results were evaluated using the Kirkaldy-Willis criteria and VAS score before and after surgery. Results: In group I, 9 cases underwent surgery and 11 cases underwent conservative treatment, without any significant differences in the clinical results. In group II, 35 cases underwent surgery and 24 cases underwent conservative treatment. Excellent results were obtained in 18(51.4%) cases, good in 15(42.9%) and 2(5.7%) were below fair. The average VAS score in group II given conservative treatment 8.9 preoperatively and 6.5 at the final follow up. Tn group II given surgical treatment the average VAS score was 9.2 preoperatively and 4.1 at the final follow up. There was a significant difference in the outcome (P�0.05). Conclusion: Patients with a degenerative lumbar deformity with accompanying lumbar scoliosis and kyphosis, scoliosis �20。or lordosis �20。are expected to show more improvement in symptom after surgery than after conservative treatment.