|
Objective:Degenerative Scoliosis(DS),the primary scoliosis, not only occurs with spinal degenerative changes after the bones mature,but also has no scoliosis in the past. Degenerative scoliosis occurs in the lumbar and thoracolumbar. It manifests in a wide range of lumbar intervertebral disc degeneration, facet joint hyperplasia, hypertrophy of ligamentum flavum and lumbar scoliosis, and even accompanies by rotation subluxation and the spine loss of balance.In addition to the ugly appearance, it can also lead to persistent low back pain,nerve root pain and intermittent claudication,part of severely patients need surgery.With the aging of the current rapid progress in the community,degenerative scoliosis,as a serious degenerative disease, is a marked increase in the incidence rate.Degenerative scoliosis is an important reason for causing low back pain,lower limb pain, intermitten t claudication in elderly patients.This study aimed to discuss clinic effect of posterior pedicle screw-rod fixation in the treatment of degenerative scoliosis,to shows that the surgical treatment of degenerative scoliosis is a safe and effective method.Methods:The clinical data of 14 degenerative scoliosis patients during 2007-2010 underwent posterior pedicle screw-rod fixation surgery.There were 6 male and 8 female with 61.8 years old on the average(ranging from 51 to 80 years),and all patients had posterior.Decompression and interver-tebral implanted bone fusion.During 6-12 months follow-up, the therapeutic effects were evaluated according to Oswestry scores,JOA scores, posto-perative imaging examination and the complication.Results:All operations were performed successfully,no death and infection in perioperation.There was 1 patient had delayed wound healing and 2 ones appeared lower limb pain, but sysptoms were remission after 4-6 conservative treatment. Remission of back pain in another patient is not obvious.14 cases were followed-up for 6-12 months.According to the average correction rate of scoliosis and the rate of pain relief,there was significantly different between that before and after operation(P<0.05).Low back pain was no significantly changed between 6 months and 1 day.Cobb angle mean value before operation was 35.36±0.45°and mean values at the moment in operation,6 months after operation were 26.29±0.94°and 26.71±0.92°.Sacral angle mean value before operation was 17.71±4.79°and mean values at the moment in operation,6 months after operation were 26.14±3.32°and 27.42±3.36°.We used ODI and JOA to estimate the rate of pain relief. Before and after operation at 1 day,6 months,ODI were 51.57±1.19,29.5±0.72,28.93±0.82;JOA were12.86±0.62,23.29±0.52,23.43±0.48.there was significant different between that before operation and after operation(P<0.05),but it was no significant different between that at the moment in operation and 6 months after operation(P>0.05).Patients were followed up from 6-12 months,there were no screw or rod breakase and no secondary scoliosis at upper or lower fused vertebral bodies as well.Conclusion:Under the premise of full decompression,posterior pedicle screw-rod fixation shows safe and effective results for degenerative scoliosis, and can achieve satisfactory outcomes for low back pain relief and improvement of radicular syndrome and neurogenic claudication.
|