Journal List > J Korean Soc Spine Surg > v.14(4) > 1035786

Choi, Shin, Jung, Kim, Kim, and Kang: Selective Pedicle Screw Fixation with Long Fusion in the Treatment of Spinal Stenosis with Degenerative Scoliosis

Abstract

Study Design

This retrospective study was designed to evaluate treatment options for spinal stenosis with degenerative scoliosis.

Purpose

To evaluate the clinical outcomes based on the degree of spinal deformity for selective pedicle screw fixation with a long fusion for spinal stenosis with degenerative scoliosis.

Materials and Methods

We reviewed 54 cases performed from March 1996 to March 2006, and divided them into three groups based on osteophyte formation, pedicular rotation, and lateral transition. The three groups were analyzed for degree of correction of scoliotic and lordotic angle and bone fusion rate, as well as radiographically and clinically using the Kirkaldy-Willis questionnaire.

Results

Mild or moderate deformities (49 cases) were improved an average of 3 degrees of scoliotic angle, grade 1 of pedicular rotation, and 1 mm of lateral transition and were satisfied clinically. Severe deformities (5 cases) improved an average of 8 degrees of scoliotic angle, grade 2 of pedicular rotation, and 3 mm of lateral transition, but were clinically unsatisfactory. There was insignificant correction of the lordotic angle in all deformities and a fusion rate of 81.5% in mild-to-moderate deformities and 40% in severe deformities.

Conclusion

Selective pedicle screw fixation with a long fusion for spinal stenosis with degenerative scoliosis is a treatment option for mild to moderate deformities.

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Figures and Tables%

Fig. 1.
A 52-year-old female with degenerative scoliosis with mild spinal deformity. (A) Preoperative anteroposterior radiograph shows 11 degrees of scoliotic angle, grade 1 pedicular rotation and 2mm lateral transition. (B) Preoperative lateral radiograph. (C) Postoperative anteroposterior radiograph shows 2 degrees of scoliotic angle, grade 0 pedicular rotation and 1mm lateral transition. (D) Postoperative lateral radiograph.
jkss-14-278f1.tif
Fig. 2.
A 62-year-old female with degenerative scoliosis with severe spinal deformity. (A) Preoperative anteroposterior radiograph shows 26 degrees of scoliotic angle, grade 2 pedicular rotation and 5mm lateral transition. (B) Preoperative lateral radiograph. (C) Postoperative anteroposterior radiograph shows 11 degrees of scoliotic angle, grade 1 pedicular rotation and 2mm lateral transition. (D) Postoperative lateral radiograph.
jkss-14-278f2.tif
Table 1.
Kirkaldy-Willis Questionnaire
Mild (Cases) Moderate (Cases) Severe (Cases)
Excellent The patient has returned to his normal work and other activities with little or no complaint 13 11
Good The patient has returned to his normal work but may on occasion after heavy work have recurrent back pain requiring a few day's rest 17 11 1
Fair The patient has to reduce his working part-time, and may occasionally have recurrence of pain requiring absence from work for one to two weeks, once or twice a year 15 16 2
Poor The patient does not return to work 11 15 2
Total 26 23 5
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