Comparison of Short Fusion versus Long Fusion for Degenerative Lumbar Scoliosis

Abstract

Purpose: To compare the results of short fusion versus long fusion for degenerative lumbar scoliosis. Materials and Methods: Forty-seven patients undergoing short fusion (n=28) and long fusion and instrumentation (n=19) were evaluated. Short fusion was defined as fusion within the deformity, not exceeding the upper end vertebra. Long fusion was defined as fusion extended above the upper end vertebra. The number of levels fused in the short and long fusion groups was 3.14 and 6.89 segments, respectively. Results: Before surgery, the Cobb angle was 16.3o in the short fusion group and 22o in the long fusion group, which changed to 10.1o and 8.47o, respectively, at the last visit. The correction of coronal imbalance was better in the long fusion group. In contrast, the correction of sagittal imbalance was similar in both groups. The mean estimated blood loss in the short and long fusion groups was 1,671 ml and 2,742 ml, respectively. Early perioperative complications developed frequently in the long fusion group. Adjacent segment disease occurred more frequently in the short fusion group. Conclusion: Long fusion and instrumentation for degenerative lumbar scoliosis was better at correcting the coronal deformity and imbalance than short fusion but was ineffective in correcting the sagittal imbalance.