Local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis / 中国组织工程研究

ABSTRACT

BACKGROUND:Conservative treatment is mostly invalid in treatment of severe degenerative lumbar scoliosis-induced low back pain, so surgical intervention is general y required. Repair methods are decompression, rigid fixation, and selective interbody fusion for the“responsible vertebra”to re-establish normal lumbar curvature, spinal balance and good stability. OBJECTIVE:To investigate clinical curative effect of local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis. METHODS:Data of 57 cases of degenerative lumbar scoliosis from Armed Police Corps Hospital of Hunan Province from January 2011 to January 2014 were retrospectively analyzed. According to clinical characteristics of the patients, selective fusion, local decompression and pedicle screw fixation were used for repair. The imaging analysis and Suk criteria were used to evaluate fixation, decompression and bone fusion. Japanese Orthopaedic Association scores were utilized to assess therapeutic effect. RESULTS AND CONCLUSION:(1) Operation time was 157-255 minutes, averagely 176 minutes. Amount of bleeding was 480-1 700 mL, averagely 835 mL. Postoperative drainage volume was 140-210 mL, averagely 155 mL. (2) 57 patients were fol owed up for 12-38 months. Postoperative X-ray revealed that Cobb’s angle was (3.8±2.1)° on the coronal plane after treatment, and the correction rate of lordosis was 54%. The sagittal Cobb’s angle was (6.3±10.5)°, and the correction rate of lordosis was 35%. According to Suk standard, the fusion rate of vertebra was 95%. According to low back pain score system recommended by Japanese Orthopaedic Association scores, the effective rate was 91%at the end of fol ow-up. (3) There were 2 cases of cerebrospinal fluid leakage, 1 case of nerve injury, and 1 case of pedicle screw failure, no infection, no blood vessel injury. (4) These findings suggest that according to imaging data and self clinical features, local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis can rebuild and stabilize degenerative lumbar scoliosis in the coronal and sagittal planes to different degrees, with satisfactory clinical curative effect.