Abstract
Introduction
The surgical treatment of adult scoliosis still presents many points of discussion. Decision-making on the type of treatment is mandatory to evaluate all the possible alternatives to surgery.
Materials and methods
From January 2000 to December 2008, 49 cases of adult degenerative scoliosis and kyphoscoliosis were surgically treated. Thirty-six patients were monitored for a mean of 8 years (5–10). There were 10 males and 26 females, with a mean age of 66 years (55–80). Arthrodesis was carried out using pedicle screws at all levels extending to the sacrum in 30 cases and to the ileum in 4. Laminectomy was performed in 20 cases, radicular liberation in 15, PLIF in 10.
Results
After an average term of 8 years (5–10) we record 8 (23 %) excellent cases, 10 (29 %) good, 12 (34 %) satisfactory, 5 (14 %) bad. The VAS in the pre-operative period had a value of 7 (5–9) passed in the post-operative period of 3 (0–6). 13 reoperations were performed (36 %).
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References
Aebi M (2005) The adult scoliosis. Eur Spine J 14:92548
Kostuick JP, Bentivoglio J (1981) The incidence of low-back pain in adult scoliosis. Spine 6:268–273
Perennou D, Marcelli C, Héricson C, Simon L (1994) Adult lumbar scoliosis. Epidemiological aspects in a low back pain population. Spine 19:123–128
Jimbo S, Kobayashi T, Aono K, Atsuta Y, Matsumo T (2012) Epidemiology of degenerative lumbar scoliosis: community based cohort study. Spine 37:1763–1770
Robin GC, Span Y, Steinberg R, Makin M, Menczel J (1982) Scoliosis in elderly: a follow-up study. Spine 7:355–359
Vanderpool DW, James JI, Wynne-Davies R (1969) Scoliosis in elderly. J Bone Joint Surg Am 51:446–455
Benner B, Ehni G (1979) Degenerative lumbar scoliosis. Spine 4:548–552
Briard J, Jeugou L, Cauchoix D (1979) Adult lumbar scoliosis. Spine 4:526–532
Seo JY, Hwang TH, Kim KW, Kim YH (2011) Risk of progression of degenerative lumbar scoliosis. J Neurosurg Spine 15:558–566
Bradford DS, Tay BK, Hu SS (1999) Adult scoliosis: surgical indications. Operative management, complications and outcome. Spine 24:2617–2629
Jackson RP, Simmons EH, Stripinis D (1983) Incidence and severity of back pain in adult idiopathic scoliosis. Spine 8:749–756
Schwab FJ, Smith VA, Biserni M, Gamez L, Farcy JP, Pagala M (2002) Adult scoliosis. A quantitative radiographic and clinical analysis. Spine 27:387–392
Glassman SD, Schwab FJ, Bridwell Kh, Ondra SL, Breven S, Lenke LG (2007) The selection of operative versus nonoperative treatment in patients with adult scoliosis. Spine 32:93–97
Bridwell KH, Berven S, Eduards CII et al (2007) The problems and limitations of applying evidence-based medicine to primary surgical treatment of adult spinal deformity. Spine 32:S135–S139
Daubs KD, Lenke LG, Chen G, Stobbs G, Bridwell KH (2007) Adult spinal deformity surgery. Complications and outcomes in patients over age 60. Spine 32:2238–2244
Cho KJ, Suk S-II, Park SR, Kim JH, Kim SS, Choi WK, Lee KY, Lee SR (2007) Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis. Spine 32:2232–2237
Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D, Study Group on Scoliosis (2012) Cpmplications and risk factors of primary adult scoliosis surgery: a multicentre study of 306 patients. Spine 37:693–700
Sansur CA, Smith JS, Coe JD, Glassman SD, Breven SH, Polly DW Jr, Perra JH, Boachie-Adjei O, Schaffrey CL (2011) Scoliosi research society morbility and mortality of adult scoliosis surgery. Spine 36:E593–E597
O’Shaughnessy BA, Bridwell KH, Lenke LG, Cho W, Baldus C, Chang MS, Auerbach JD, Crawford CH (2012) Does a long fusion “T3-sacrum” ported a worse outcome than fusion “T10-sacrum” in primary surgery for adult scoliosis? Spine 37:884–890
Kim YJ, Bridewll KH, Lenke LG, Rhim SR, Chen G (2006) Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum: prevalence and risk factor analysis of the 144 cases. Spine 31:2329–2336
White AH, von Rogov P, Zucherman J, Heiden D (1987) Lumbar laminectomy for herniated disc: a prospective controlled comparison with internal fusion. Spine 12:3057
O’shaughnessy BA, Lenke LG, Bridwell KH, Cho W, Zebala LP, Chang MS, Auerbach JD, Crawford CH, Koester LA (2012) Should symptomatic iliac screw be electively removed in adult spinal deformity patients fused to the sacrum? Spine 37:1175–1181
Cho KJ, Suk S-II, Park SR, Kim JH, Choi SW, Yoon YH, Won MH (2009) Arthrodesis to L5 versus S1 in long instrumentation and fusion for degenerative scoliosis. Eur Spine J 18:531–537
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Palmisani, M., Dema, E. & Cervellati, S. Surgical treatment of adult degenerative scoliosis. Eur Spine J 22 (Suppl 6), 829–833 (2013). https://doi.org/10.1007/s00586-013-3012-1
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DOI: https://doi.org/10.1007/s00586-013-3012-1