Surgical Treatment of Degenerative Lumbar Scoliosis with Multiple Spinal Stenosis

Abstract

Purpose : To evaluate changes of scoliotic angle and adjacent segments after surgical treatment of degenerative lumbar scoliosis with multiple spinal stenosis. Materials and Methods : 23 patients of mutiple spinal stenosis with more than 10 degree of scoliotic angle were retrospectively reviewed from March, 1997 to May, 2001. All patients underwent wide total laminectomy & instrumentation by fixation of pedicle screw and autogenous bone graft. And their average of follow up period was 21 months. Lordotic and scoliotic angle was measured with Cobb’s method by using simple X-ray. And degenerative scoliosis was analyzed by Simmons’ Classification. Results : Fusion was performed in 3.1 segments and wide total laminectomy was performed in 2.6 segments. And in type I of Simmons’ classification degenerative scoliosis found in 15 cases, and 8 cases in type II. After the surgical correction scoliotic angle was decreased from 14 to 8 degrees, and the lordotic angle increased from 14 to 19 degrees. And no significant changes was found in the last follow up. 16 cases (70%) showed the “excellent” and “good” clinical results and Simmons type II showed better clinical results than those of type I (type I was 9 cases and type II was 7 cases). Conclusion : Patients with degenerative lumbar scoliosis with multiple spinal stenosis treated with wide total laminectomy and instrumentation by fixation of pedicle screw showed effects in coronal and sagittal balance, and considering instability resulting from involvements in multiple segments and other complex pathologic conditions seems to be important.