Posterior decompression and in situ fusion for the treatment of degenerative scoliosis

Surgical Principles Asymmetric disc degeneration in the lumbar spine often creates a segmental instability that will result in progressive arthrosis of the facet joints and development of a lumbar scoliosis. Although the progression of the curve is slow, it may cause in the adult and elderly significant back pain and radicular pain [2, 3]. If conservative management fails, then surgical treatment should consist of a thorough decompression of the involved nerve roots and fusion of the involved vertebral segments. The technique described advocates an in situ fusion with no attempt at correction of the deformity and no use of instrumentation. This procedure is often required in elderly, osteopenic patients with systemic illnesses and therefore is designed to minimize intra- and postoperative morbidity.