Long-Term Results in Patients Treated with Posterior Instrumentation and Fusion for Degenerative Scoliosis of the Lumbar Spine |
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Authors: | Zurbriggen C Markwalder T-M Wyss S |
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Institution: | (1) Neurosurgeon, Bern, Switzerland, CH |
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Abstract: | Summary The authors report a homogeneously investigated and surgically treated series of 4 0 patients with degenerative scoliosis
of the lumbar spine. The series included 22 females and 18 males with a mean age of 62.8 years. The clinical presentation,
the diagnostic work-up, the indication for surgery, the surgical techniques and results are reported. Final evaluation was
possible in 30 patients at a mean period of observation of 59.5 months. Following a very precise diagnostic and therapeutic
protocol excellent, good and satisfactory surgical results were obtained in 13 (43.3%), 16 (53.3%) and 1 (3.3%) patients,
respectively. While scoliosis was converted from a mean preoperative Cobb angle of 18.7° to 7.6° mean pre-operative lumbar
lordosis was slightly augmented from 37° to 41.5°. The results suggest that maintainance or correction of lumbar lordosis
is more important than the conversion of the scoliotic deformity which is probably treated sufficiently by partial correction
and stabilization.
Observation over time indicates that the degenerative cascade evolves despite internal fixation and fusion in the majority
of the patients until a stable state is reached. This stable state is probably rather the result of ankylosis of the facet
joints than the effect of posterolateral fusion. |
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Keywords: | : Lumbar spine scoliosis lumbar fusion |
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