Selective interbody fusion combined with pedicle screw fixation for degenerative lumbar scoliosis: spinal stability

doi:10.3969/j.issn.2095-4344.2015.26.015

Abstract

Abstract:

BACKGROUND: Degenerative lumbar scoliosis often appeared in the elderly, who may combine with other diseases, which can cause poor repair tolerance. Degenerative lumbar scoliosis commonly has a responsible vertebral body, so local decompression and selective fusion should be conducted. This can achieve nerve decompression, spinal stability, and is relatively minimally invasive.
OBJECTIVE: To explore the efficacy of selective interbody fusion, limited neural decompression combined with pedicle screw system fixation for degenerative lumbar scoliosis.
METHODS: Clinical characteristics of 53 patients with degenerative lumbar scoliosis were retrospectively analyzed, and the indication and contraindication were investigated. Selective interbody fusion, and limited neural
decompression combined with pedicle screw system fixation were performed in the patients. Treatment effect and complication were analyzed. During follow-up, Suk standard was utilized to judge bone graft fusion. Before treatment and during final follow-up, lower back pain score system recommended by the Japanese Orthopaedic Association was used for assessment, and the excellent and good rate of curative effects was calculated. Cobb’s angle on the sagittal and coronal positions was compared and analyzed before and after treatment.
RESULTS AND CONCLUSION: The patients were followed up for 12 to 36 months. According to low back pain score of Japanese Orthopaedic Association Scores, the excellent and good rate of curative effect was 89% during the last follow-up. According to Suk standard, the fusion rate of vertebra was 94%. The last X-ray films revealed that Cobb’s angle was averagely (4.3±2.3)° (0°-13.5°) on the coronal plane after treatment, and the correction rate of scoliosis was 56%. The Cobb’s angle was averagely (45.1±12.5)° (10.4°-65.3°) after treatment, and the correction rate of lordosis was 36%. Complications after repair consisted of cerebrospinal fluid leakage in two cases, nerve injury in two cases, instrumental failure in one case, and pulmonary infection in one case, and symptomatic deep venous thrombosis in three cases. These findings suggest that selective interbody fusion, and limited neural decompression combined with pedicle screw system fixation were effective and safe for degenerative lumbar scoliosis. The sequence of the lumbar vertebra on the coronal and the sagittal planes received reconstruction to different degrees, and could realize the stability of the lumbar vertebrae in the scoliosis.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Scoliosis, Lumbar Vertebrae, Internal Fixators, Bone Nails, Follow-Up Studies

CLC Number:

R318

Yin Cheng-hui, Fu Chen-xue, Ye Yong-ping, Xu Hao. Selective interbody fusion combined with pedicle screw fixation for degenerative lumbar scoliosis: spinal stability[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(26): 4174-4179.

Figures/Tables 2

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