Operative Treatment of Degenerative Scoliosis / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: The retrospective study was designed to propose treatment options of degenerative scoliosis OBJECTIVES: To propose various treatment options based on patients'clinical symptoms & radiologic findings and finally to get a standard treatment options. SUMMARY OF LITERATURE REVIEW The studies about the treatment options of degenerative scoliosis were few, so we propose the treatment options of degenerative scoliosis. MATERIALS & METHODS: Between January, 1994 and August, 2000, 136 cases of degenerative scoliosis were diagnosed. Among these cases, 45 cases (33%) were performed operative treatment. There were 45 women and 4 men. The average patients age was 62.6 years (range 43~78years). The average follow up time was 23 months (range 12 mon~66 months). Scoliotic angle within curve was measured by Cobb's methods, and rotation of pedicles were measured by Nash and Moe methods. RESULTS: The overall satisfactory clinical results was noted in 37 (82%) of 45 patients. By Kirkardy-Willis questionnaire, 14 cases were excellent, 23 cases were good, 5 cases were fair, 3 cases were poor. Before surgery, average Cobb's angle measured 16 degree (range 7~44 degree), after surgery, this corrected to 9.2 degree (range 2~25 degree). But, degree of improvement in Cobb's angle and one of clinical symptom relief had no statistic correlations (p>0.05). CONCLUSION: 1) When neurologic symptoms were chief complaints, and scoliosis curvature was stable. only decompression surgery should be performed. 2) when mild back pain and neurologic symptoms were chief complaints, and rotatory subluxation at stenotic level, decompression & limited post. instrumentation & fusion. 3) when severe back pain and neurologic symptoms were chief complaints, and scoliosis curvature was unstable, decompression & long post. instrumentation & fusion. 4) When only technical pain-no neurologic symptoms-was a chief complaints, correction & fusion with instrumentation.