Medium to long-term curative effects of long-segmental fixation and fusion on degenerative scoliosis

摘要

Objective: To evaluate the medium to long-term curative effects of surgical long segmental fixation and fusion in degenerative scoliosis (DS). Patients and methods: From January 2001 to December 2011, 56 DS patients underwent long segmental fixation and fusion. Clinical data, including visual analogue scale (VAS) scores, Oswestry disability index (ODI), lumbar lordosis angles, coronary Cobb angles and postoperative complications were followed up for 2 to 12 years postoperatively. Results: VAS and ODI scores were significantly improved 1 year postoperatively compared to the preoperative values (P = 0.000). Coronary Cobb angles were significantly improved three months postoperatively (P = 0.001) but ≥ 1 year after surgery there was no further significant improvement compared to the preoperative values (P = 0.585). The lumbar lordosis angle was not significantly changed postoperatively (P > 0.05). Conclusions: Favorable medium to long-term curative effects can be achieved by long segmental fixation and fusion. Ideally, the fixation and fusion segments should be longer than the segments affected by scoliosis. The restoration of the lumbar lordosis angle is the key to rebuilding sagittal balance, which is closely correlated with a patient’s clinical symptoms and quality of life.