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European Spine Journal

Erschienen in:

06.11.2019 | Original Article

Curve progression in de novo degenerative lumbar scoliosis combined with degenerative segment disease after short-segment fusion

verfasst von: Yongqiang Wang, Ang Gao, Enhamujiang Hudabardiy, Miao Yu

Erschienen in: European Spine Journal | Ausgabe 1/2020

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Abstract

Purpose

To validate the reliability of Berjano and Lamartina classification system of surgical planning in cases of de novo degenerative lumbar scoliosis (DNDLS) combined with degenerative segment disease and identify factors contributing to curve progression.

Methods

Fifty-four cases of type I or II DNDLS were retrospectively reviewed. Health-related quality of life (HRQOL) was assessed using visual analogue scale (VAS) scores for the back and leg, Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores. Radiographic parameters were obtained from X-rays. Improvements in HRQOL were confirmed by a paired t test. Changes in radiographic parameters were confirmed by paired t test and Wilcoxon signed-rank test. Clinical relevance between spinopelvic parameters and Cobb angle progression was analyzed by Spearman correlation coefficient.

Results

The mean follow-up period was 36.8 ± 14.8 months. The scores taken preoperatively versus at the last follow-up were as follows: mean VAS back score, 4.5 ± 2.4 versus 1.8 ± 1.5 (p < 0.01); and mean VAS leg score, 5.2 ± 2.5 versus 1.7 ± 2.1 (p < 0.01). The ODI score improved from 25.3 ± 8.9% to 10.1 ± 5.4% (p < 0.01), whereas the mean JOA score improved from 14.3 ± 4.9 to 21.0 ± 3.7 (p < 0.01). The mean Cobb angle decreased from 17.1° ± 7.4° to 9.4° ± 4.5° postoperatively but worsened to 14.1° ± 6.4° at the last follow-up with a mean progression of 2.1° per year. Cobb angle correction was lost at a mean 2.1° ± 3.3° per year with correlation to T1 pelvic angle and sagittal vertical axis preoperatively.

Conclusions

Selective decompression and short-segment fusion were effective for treating type I and II cases DNDLS. The Cobb angle increased relative to preoperative sagittal spine alignment.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

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Titel: Curve progression in de novo degenerative lumbar scoliosis combined with degenerative segment disease after short-segment fusion
verfasst von: Yongqiang Wang
Ang Gao
Enhamujiang Hudabardiy
Miao Yu
Publikationsdatum: 06.11.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 1/2020
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-06173-0

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Curve progression in de novo degenerative lumbar scoliosis combined with degenerative segment disease after short-segment fusion