The surgical final result of decompression alone versus decompression with restricted fusion for degenerative lumbar scoliosis.
J Neurosurg Backbone. 2018 Jun 01;:1-6
Authors: Masuda Ok, Higashi T, Yamada Ok, Sekiya T, Saito T
OBJECTIVE The goal of this examine was to evaluate the usefulness of radiological parameters for surgical decision-making in sufferers with degenerative lumbar scoliosis (DLS) by evaluating the scientific and radiological outcomes after decompression or decompression and fusion surgical procedure. METHODS The authors prospectively deliberate surgical therapy for 298 sufferers with degenerative lumbar illness between September 2005 and March 2013. The surgical methodology used at their establishment to deal with intervertebral instability is exactly outlined based mostly on radiological parameters. Amongst 64 sufferers with a Cobb angle starting from 10° to 25°, 57 sufferers who underwent follow-up for greater than 2 years postoperatively had been evaluated. These sufferers had been divided into 2 teams: these within the decompression group underwent decompression alone (n = 25), and people within the fusion group underwent decompression and brief segmental fusion (n = 32). Surgical outcomes had been reviewed, together with preoperative and postoperative Cobb angles, lumbar lordosis based mostly on radiological parameters, and Japanese Orthopaedic Affiliation (JOA) scores. RESULTS The JOA scores of the decompression group and fusion group improved from 5.9 ± 1.6 to 10.zero ± 2.eight and from 7.2 ± 2.zero to 11.three ± 2.eight, respectively, which was not considerably totally different between the teams. On the closing follow-up, the postoperative Cobb angle within the decompression group modified from 14° ± 2.9° to 14.three° ± 6.four° and remained steady, whereas the Cobb angle within the fusion group decreased from 14.eight° ± four.zero° to 10.zero° ± eight.5° after surgical procedure. CONCLUSIONS The sufferers in each teams demonstrated improved JOA scores and preserved Cobb angles after surgical procedure. The advance in JOA scores and preservation of Cobb angles in each teams present that the analysis of spinal instability utilizing radiological parameters is suitable for surgical decision-making.
PMID: 29856301 [PubMed – as supplied by publisher]