Limited decompression, fixation, and fusion for degenerative scoliosis with vertebral stenosis

Abstract

Objective To evaluate the efficiency of limited decompression, fixation, and fusion for degenerative scoliosis with vertebral stenosis. Methods From January 2001 to January 2008, 36 patients with degenerative scoliosis with vertebral stenosis were treated in our hospital. There were 2 males and 34 females. The age was from 51 to 76 years with an average of 62.3 years. X-ray, CT, MR examination were performed preoperatively for all the cases, 5 cases underwent myelography. Preoperative Cobb's angle, focal lordosis, the distance between C_7 plumb line(C_7PL) and upper edge of S_1 vertebral body (SVA), and the distance between C_7PL and center sacral vertical line(CSVL) were 24.0°±10.2°, 22.6°±11.2°, (7.8±6.6) cm and (6.9±5.8) cm respectively. Limited decompression, pedicle screw internal fixation and fusion were carried out for patients, VAS and SF-36 scored system were used to evaluate surgery effects. Results The mean followup period was 2.4 years (range, 1.2-4 years) and no patients were lost during follow-up. The mean surgery time was 130 min (range, 115-164 min) with an average bleeding amount of 625 ml (range, 450-870 ml). Compared to preoperation, Cobb's angle (10.6°±8.5°, 8.9°±5.3°), focal lordosis (25.6°±14.3°, 31.8°±13.4°), SVA[(0.5±3.4) cm, (-1.2±2.7) cm], and CSVL [(2.9±1.4) cm, (1.7±1.2) cm] were significantly improved at postoperation and final follow-up through statistics of SPSS 13.0 software. Loss of correction happened in one case. No collapse of the disc height occurred, neither did nerve root injuries nor fracture of the fixation system. Conclusion Limited decompression, pedicle screw fixation and fusion are testified efficient for degenerative scoliosis with vertebral stenosis, individualized surgery design should be made according to clinical symptoms, signs and imaging features to expect a satisfactory result. Key words: Lumbar vertebrae; Spinal stenosis; Scoliosis