Posterior spinal decompression combined with facet V-osteotomy for correction of degenerative lumbar scoliosis

Abstract

Objective To explore the effects of posterior spinal decompression combined with facet V-osteotomy on patients with degenerative lumbar scoliosis.Method 42 patients with degenerative lumbar seoliosis(from Jan 2002 to Sep 2008)were analyzed retrospectively..Mean age at time of surgery was 65 years(range 54～71 years),mean history was 8.5 years(range 6 months-18years),the average Cobb angle of lumbar scoliosis was 32.4°(range 20°～68°)before operation.The Cobb angle(°)of lumbar scoliosis,thoracolumbar kyphosis and lumbar lordosis,L_3 and L_4 vertebrae obliquity(°),apical vertebrae offset dis-tance(cm),trunk deviation(cm)and the C7 vertebral body center plumb line from the upper edge of post-S1 distance(cm)between pre-and post-operation were compared.The outcome judgment based on the JOA score criteria from follow-up.Result The follow-up period of post-operation of these 37 cases were from 12 months to 6.5 years with an average of 2.5 years.The data in early postoperative showed that the average correction in coronal Cobb angle,thoracolumbar kyphosis and lumbar lordosis was 17.9°±3.3°(correction rate 55%),3.8°±1.6°(correction rate 51%),13.4°±4.9°,respectively.Correction in apical verte-brae offset distance,L_3 and L_4 vertebrae obliquity was(1.9±0.7)cm,4.1°±1.3°and 5.4°±2.6°,re-spectively.Coronal and sagittal balance were significantly improved [average correction(1.8 ±1.0)cm,(3.6±1.1)cm],compared to those in pre-operation.The result in the last time of follow-up showed that coronal Cobb angle increased 2.4°±0.5°.thoracolumbar kyphosis increased 2.6°±1.1°,and sagittal plane deviation increased(1.2±0.4)cm.However,pseudarthrosis was not found in any patient at final fol-low-up,excellent and good rate of treatment effect wag 84%.Conclusion For the Cobb angle less than 70°,posterior spinal decompression combined with facet V-osteotomy can effectively improve the coronal and sagittal plane balance of degenerative lumbar scoliosis,the results are satisfactory. Key words: Decompression,surgicaL/MT; Spinal Canal/SU; Osteotomy/MT; Zygapophyseal Joint/SU; Scoliosis/SU; Lumbar Vertebrae