Surgical Treatment of Degenerative Lumbar Scoliosis with Multiple Spinal Stenosis

2002 ◽  
Vol 9 (3) ◽  
pp. 197 ◽  
Author(s):  
June-Kyu Lee ◽  
Jun-Young Yang ◽  
Kyung-Cheon Kim
Keyword(s):  
Surgical Treatment ◽  
Spinal Stenosis ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis

scholarly journals Outcome of Surgical Treatment for Degenerative Lumbar Scoliosis

2012 ◽  
Vol 61 (3) ◽  
pp. 355-361
Author(s):  
Yoshikazu Yanagisawa ◽  
Hiroshi Nomura ◽  
Atsuko Kohyama ◽  
Kensuke Hotta ◽  
Satoshi Kido ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis

scholarly journals Comparison between dynamic stabilization and instrumented fusion in the treatment of spinal stenosis with degenerative lumbar scoliosis

2019 ◽  
Author(s):  
Lei Luo ◽  
Lang Fang ◽  
Qiang Zhou ◽  
Chen Zhao ◽  
Pei Li ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Spinal Stenosis ◽  
Perioperative Complications ◽  
Dynamic Stabilization ◽  
Degenerative Lumbar Scoliosis ◽  
Instrumented Fusion ◽  
Lumbar Scoliosis ◽  
Significant Difference ◽  
Posterior Instrumented Fusion

Abstract Background Posterior instrumented fusion is the most widely accepted surgical treatment for spinal stenosis with degenerative lumbar scoliosis (DLS). However, long fusion can affect daily activities due to lumbar stiffness. Several clinical studies have shown that Dynesys dynamic stabilization in addition to laminectomy could lead to significant improvements in clinical outcomes. This study aimed to compare the outcomes of Dynesys dynamic stabilization with posterior instrumented fusion for the management of spinal stenosis with DLS. Methods Between August 2010 and Deccember 2015, a total of 46 patients with spinal stenosis and degenerative lumbar scoliosis were enrolled in this study. 26 patients (Dynesys group) had fenestration decompression, selective intervertebral fusion and Dynesys stabilizationin. 20 patients (fusion group) underwent posterior instrumented fusion. Clinical outcomes, radiographic data, and perioperative complications were compared between the two groups. The average duration of follow-up for the Dynesys group and fusion group was 38 and 33 months respectively. Results The mean number of fixed segments were 3.3±0.8 in Dynesys group and 4.3±0.8 in fusion group. Lower average values of operative duration and blood loss were observed in the dynamic group than in the fusion group. VAS for back and leg pain improved in both groups of patients. There were significant difference in ODI and LSDI (lumbar stiffness disability index) between Dynesys group and fusion group at the last follow-up. The scoliosis Cobb's angle and lumbar lordosis significantly improved in both groups after surgery, and no significant difference were observed between the groups at the last follow-up (P＞0.05). Dynesys stabilization resulted in significantly higher preservation of motion at the implanted segments. Conclusions This study demonstrated that both Dynesys dynamic stabilization and instrumented fusion can improve clinical outcomes of patients with degenerative lumbar scoliosis. Compared to instrumented fusion, Dynesys stabilizationin have advantages on blood loss, operation time, perioperative complications. In addition, Dynesys stabilization partially preserves the ROM of the stabilized segments that may reduce the limitation on daily activities caused by lumbar stiffness. Dynesys stabilizationin can also correct scoliosis, prevent progression of the curve, and maintain lumbar lordosis in mild to moderate lumbar scoliosis without sagittal imbalance.

scholarly journals Can decompression surgery relieve low back pain in patients with lumbar spinal stenosis combined with degenerative lumbar scoliosis?

2013 ◽  
Vol 22 (9) ◽  
pp. 2010-2014 ◽  
Author(s):  
Shunji Tsutsui ◽  
Ryohei Kagotani ◽  
Hiroshi Yamada ◽  
Hiroshi Hashizume ◽  
Akihito Minamide ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Decompression Surgery ◽  
Degenerative Lumbar Scoliosis ◽  
Low Back ◽  
Lumbar Scoliosis ◽  
Lumbar Spinal

Decompression and nonfusion dynamic stabilization for spinal stenosis with degenerative lumbar scoliosis

2014 ◽  
Vol 21 (4) ◽  
pp. 585-594 ◽  
Author(s):  
Soo Eon Lee ◽  
Tae-Ahn Jahng ◽  
Hyun-Jib Kim
Keyword(s):  
Spinal Stenosis ◽  
Radiolucent Line ◽  
Decompressive Surgery ◽  
Neurological Deficits ◽  
Spinal Diseases ◽  
Degenerative Lumbar Scoliosis ◽  
Moderate Degree ◽  
Lumbar Scoliosis ◽  
The Mean

Object Spinal stenosis with degenerative lumbar scoliosis (DLS) mostly occurs in the elderly population (typically > 65 years old), causing pain in the legs and back, claudication, and spinal deformity. The surgical strategy for DLS is controversial concerning the surgical approach, fusion area, decompression area, correction methods, and ideal angle of curve correction. A nonfusion stabilization system with motion preservation has been recently used for degenerative spinal diseases with favorable outcomes. This study attempted to analyze surgical outcomes after decompression and nonfusion stabilization for spinal stenosis with a mild to moderate degree of DLS. Methods Twenty-eight patients (21 women and 7 men, with a mean age of 65.3 years) with spinal stenosis and DLS who underwent decompressive surgery and nonfusion stabilization with the Dynesys system were included in this study. Medical records and radiological studies were reviewed to access clinical and radiological outcomes and surgery-related complications. Results Fifty-nine segments were decompressed and stabilized without fusion in 28 patients, consisting of 1 segmental stabilization in 8 patients (28.6%, L4–5), 2 segmental stabilizations in 11 patients (39.3%, L3–5), 3 segmental stabilizations in 7 patients (25.0%, L2–5 in 6 patients, L3–S1 in 1 patient), and 4 segmental stabilizations in 2 patients (7.1%, L2–S1 in 1 patient, L1–5 in 1 patient). The mean follow-up period was 30.7 months. Radiologically, the mean lumbar scoliotic angle was 13.7° before surgery, 5.1° at 3 months postoperatively, 3.8° at 12 months postoperatively, 4.2° at 24 months postoperatively, and 3.9° at the last follow-up, which was statistically significant (p < 0.05). Lumbar lordosis and range of motion were preserved. The score on the visual analog scale for leg and back pain significantly decreased, and the Oswestry Disability Index significantly improved after surgery. There were no newly developed neurological deficits or aggravation of neurological symptoms. A radiolucent line around the pedicle screw was observed in 4 patients (14.2%) with 5 screws (2.8%). Conclusions Adding nonfusion stabilization after decompressive surgery resulted in a safe and effective procedure for elderly patients with lumbar stenosis with a mild to moderate scoliosis angle (< 30°). Statistically significant improvement of the clinical outcome was obtained at the last follow-up evaluation with no progression of the degenerative scoliosis.

scholarly journals MINIMALLY INVASIVE SURGICAL TREATMENT FOR ADULT DEGENERATIVE LUMBAR SCOLIOSIS

2018 ◽  
pp. 49-56 ◽  
Author(s):  
Aleksandr Vladimirovich Krutko ◽  
Peter Durny ◽  
Andrey Igorevich Vasilyev ◽  
Aleksandr Vasilyevich Bulatov
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis ◽  
Minimally Invasive Surgical ◽  
Minimally Invasive Surgical Treatment

scholarly journals Comparison of percutaneous transforaminal endoscopic decompression and short-segment fusion in the treatment of elderly degenerative lumbar scoliosis with spinal stenosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Pengfei Li ◽  
Yuexin Tong ◽  
Ying Chen ◽  
Zhezhe Zhang ◽  
Youxin Song
Keyword(s):  
Cobb Angle ◽  
Clinical Outcomes ◽  
Spinal Stenosis ◽  
Disc Height ◽  
Degenerative Lumbar Scoliosis ◽  
Short Segment ◽  
Lumbar Scoliosis ◽  
Endoscopic Decompression ◽  
Significant Difference ◽  
Segmental Lordosis

Abstract Background Degenerative lumbar scoliosis (DLS) combined with spinal stenosis is increasingly being diagnosed in the elderly. However, the appropriate surgical approach remains somewhat controversial. The aim of this study was to compare the results of percutaneous transforaminal endoscopic decompression (PTED) and short-segment fusion for the treatment of mild degenerative lumbar scoliosis combined with spinal stenosis in older adults over 60 years of age. Methods Of the 54 consecutive patients included, 30 were treated with PTED and 24 were treated with short-segment open fusion. All patients were followed up for at least 12 months (12–24 months). Patient demographics, and perioperative and clinical outcomes were recorded. Visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and modified Macnab criteria were used to assess clinical outcomes. At the same time, changes in disc height, segmental lordosis, coronal Cobb angle, and lumbar lordosis were compared. Results The mean age was 68.7 ± 6.5 years in the PTED group and 66.6 ± 5.1 years in the short-segment fusion group. At 1 year postoperatively, both groups showed significant improvement in VAS and ODI scores compared with preoperative scores (p < 0.05), with no statistically significant difference between groups. However, VAS-Back and ODI were lower in the PTED group at 1 week postoperatively (p < 0.05). According to the modified Macnab criteria, the excellent rates were 90.0 and 91.6% in the PTED and short-segment fusion groups, respectively. However, the PTED group had a significantly shorter operative time, blood loss, postoperative hospital stay, postoperative bed rest, and complication rate. There was no significant difference in radiological parameters between the two groups preoperatively. At the last follow-up, there were significant differences in disc height, segmental lordosis at the L4–5 and L5–S1 levels, and Cobb angle between the two groups. Conclusion Both PTED and short-segment fusion for mild degenerative lumbar scoliosis combined with spinal stenosis have shown good clinical results. PTED under local anesthesia may be an effective supplement to conventional fusion surgery in elderly patients with DLS combined with spinal stenosis.

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