BACKGROUND:Conservative treatment is mostly invalid in treatment of severe degenerative lumbar scoliosis-induced low back pain, so surgical intervention is general y required. Repair methods are decompression, rigid fixation, and selective interbody fusion for the“responsible vertebra”to re-establish normal lumbar curvature, spinal balance and good stability. OBJECTIVE:To investigate clinical curative effect of local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis. METHODS:Data of 57 cases of degenerative lumbar scoliosis from Armed Police Corps Hospital of Hunan Province from January 2011 to January 2014 were retrospectively analyzed. According to clinical characteristics of the patients, selective fusion, local decompression and pedicle screw fixation were used for repair. The imaging analysis and Suk criteria were used to evaluate fixation, decompression and bone fusion. Japanese Orthopaedic Association scores were utilized to assess therapeutic effect. RESULTS AND CONCLUSION:(1) Operation time was 157-255 minutes, averagely 176 minutes. Amount of bleeding was 480-1 700 mL, averagely 835 mL. Postoperative drainage volume was 140-210 mL, averagely 155 mL. (2) 57 patients were fol owed up for 12-38 months. Postoperative X-ray revealed that Cobb’s angle was (3.8±2.1)° on the coronal plane after treatment, and the correction rate of lordosis was 54%. The sagittal Cobb’s angle was (6.3±10.5)°, and the correction rate of lordosis was 35%. According to Suk standard, the fusion rate of vertebra was 95%. According to low back pain score system recommended by Japanese Orthopaedic Association scores, the effective rate was 91%at the end of fol ow-up. (3) There were 2 cases of cerebrospinal fluid leakage, 1 case of nerve injury, and 1 case of pedicle screw failure, no infection, no blood vessel injury. (4) These findings suggest that according to imaging data and self clinical features, local decompression and selective interbody fusion with pedicle screw fixation technique for the treatment of degenerative lumbar scoliosis can rebuild and stabilize degenerative lumbar scoliosis in the coronal and sagittal planes to different degrees, with satisfactory clinical curative effect.%背景：对于严重的退变性腰椎侧凸所引起的腰背痛，保守治疗多数无效，一般需要外科干预手术治疗。修复方式多为对“责任椎”进行减压、坚强固定、选择性椎间植骨融合为主，重新建立腰椎正常曲度和脊柱的平衡及良好的稳定性。目的：探讨采用椎弓根螺钉固定局部减压与选择性椎间融合修复退变性腰椎侧凸的效果。方法：回顾性分析2011年1月至2014年1月武警湖南省总队医院收治的57例退变性腰椎侧凸患者，根据患者自身的临床特点，均采用选择性椎间融合、局部减压和椎弓根螺钉置入内固定的修复方案，以影像学分析及Suk标准评价固定、减压、植骨融合情况，日本骨科学会评分评价疗效优良率。结果与结论：①手术时间157-255 min，平均176 min；出血量480-1700 mL，平均835 mL；术后引流量140-210 mL，平均155 mL；②57例患者获得12-38个月随访，术后X射线提示，治疗后冠状面Cobb’s角(3.8±2.1)°，侧凸矫正率为54%；治疗后矢状面Cobb’s角(6.3±10.5)°，前凸矫正率为35%。Suk标准评定椎间融合率为95%；根据日本骨科学会腰背痛评分评估末次随访时患者的疗效优良率为91%；③术中硬膜囊破裂引发脑脊液漏2例，神经损伤1例，椎弓根螺钉拔出失败1例，无感染，无血管损伤；④结果说明，结合患者影像学资料与自身临床特点，采用椎弓根螺钉固定局部减压与选择性椎间融合修复退变性腰椎侧凸，可使退变的侧凸腰椎在冠状面和矢状面上均得到不同程度的重建和稳定，修复效果满意。
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