Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Tian Cheng,Paul Gerdhem

doi:10.1007/s00586-017-5248-7

Abstract

PurposeThe outcome of surgery for degenerative lumbar scoliosis was studied in the Swedish Spine register.Methods209 patients (mean age 66 years) were identified; 45 had undergone decompression and/or fusion of one segment (minor group) and 164 had undergone fusion of two or more segments, with or without decompression (major group).ResultsVAS back pain, VAS leg pain, ODI and EQ-5D index improved after surgery in both groups (p < 0.05), with medium to large effect sizes of surgery. Global assessment for back pain and satisfaction was significantly better in the major group than in the minor group (p < 0.05) at the 2-year follow-up. Additional spine surgery was observed in 57 out of the 209 patients during a mean period of 5.4 years.ConclusionSurgery for degenerative lumbar scoliosis improves quality of life with medium to large effect sizes, but carries a high risk of additional surgery.

Highlights

Degenerative lumbar scoliosis is defined as a lumbar deformity with a Cobb angle of C10° in the coronal plane developing after skeletal maturity [1]
We considered global assessment of back pain and global assessment of leg pain reported at the follow-ups as the primary outcomes [14]
After a decrease between 1 and 2 years, global assessment for back pain was significantly better in the major group than in the minor group (Table 2)

Summary

Introduction

Degenerative lumbar scoliosis is defined as a lumbar deformity with a Cobb angle of C10° in the coronal plane developing after skeletal maturity [1]. Symptoms for degenerative lumbar scoliosis are primarily chronic back pain and leg pain, and may severely reduce the health-related quality of life [5, 6]. Even though evidence for effectiveness of non-operative treatment is scarce, such attempts should be performed before surgical procedures [7]. With or without more or less extensive fusion with treatments decisions based on symptoms and pathology [6]. The risks that different surgical strategies carry are not evident. The possible risk of deformity progression after minor surgery might influence decision making towards major surgery, while comorbidities might influence the decision towards minor surgery

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Results

Conclusion