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Surgical treatment of adult degenerative scoliosis

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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

  1. Aebi M (2005) The adult scoliosis. Eur Spine J 14:92548

    Article  Google Scholar 

  2. Kostuick JP, Bentivoglio J (1981) The incidence of low-back pain in adult scoliosis. Spine 6:268–273

    Article  Google Scholar 

  3. Perennou D, Marcelli C, Héricson C, Simon L (1994) Adult lumbar scoliosis. Epidemiological aspects in a low back pain population. Spine 19:123–128

    Article  PubMed  CAS  Google Scholar 

  4. Jimbo S, Kobayashi T, Aono K, Atsuta Y, Matsumo T (2012) Epidemiology of degenerative lumbar scoliosis: community based cohort study. Spine 37:1763–1770

    Article  PubMed  Google Scholar 

  5. Robin GC, Span Y, Steinberg R, Makin M, Menczel J (1982) Scoliosis in elderly: a follow-up study. Spine 7:355–359

    Article  PubMed  CAS  Google Scholar 

  6. Vanderpool DW, James JI, Wynne-Davies R (1969) Scoliosis in elderly. J Bone Joint Surg Am 51:446–455

    PubMed  CAS  Google Scholar 

  7. Benner B, Ehni G (1979) Degenerative lumbar scoliosis. Spine 4:548–552

    Article  PubMed  CAS  Google Scholar 

  8. Briard J, Jeugou L, Cauchoix D (1979) Adult lumbar scoliosis. Spine 4:526–532

    Article  PubMed  CAS  Google Scholar 

  9. Seo JY, Hwang TH, Kim KW, Kim YH (2011) Risk of progression of degenerative lumbar scoliosis. J Neurosurg Spine 15:558–566

    Article  PubMed  Google Scholar 

  10. Bradford DS, Tay BK, Hu SS (1999) Adult scoliosis: surgical indications. Operative management, complications and outcome. Spine 24:2617–2629

    Article  PubMed  CAS  Google Scholar 

  11. Jackson RP, Simmons EH, Stripinis D (1983) Incidence and severity of back pain in adult idiopathic scoliosis. Spine 8:749–756

    Article  PubMed  CAS  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. 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

    Article  PubMed  Google Scholar 

  17. 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

    Article  PubMed  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. 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

    Google Scholar 

  22. 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

    Article  PubMed  Google Scholar 

  23. 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

    Article  PubMed  Google Scholar 

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Correspondence to Matteo Palmisani.

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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

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