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Abstract
Purpose
To evaluate changes of scoliotic angle and adjacent segments after surgical treatment of degenerative lumbar scoliosis with multiple spinal stenosis.
Materials and Methods
23 patients of mutiple spinal stenosis with more than 10 degree of scoliotic angle were retrospectively reviewed from March, 1997 to May, 2001. All patients underwent wide total laminectomy & instrumentation by fixation of pedicle screw and autogenous bone graft. A nd their average of follow up period was 21months. Lordotic and scoliotic angle was measured with Cobb's method by using simple X - ray. A nd degenerative scoliosis was analyzed by Simmons’ Classification.
Results
Fusion was performed in 3.1segments and wide total laminectomy was performed in 2.6 segments. A nd in type Ⅰ of Simmons’ classification degenerative scoliosis found in 15 cases, and 8 cases in type Ⅱ. A fter the surgical correction scoliotic angle was decreased from 14 to 8 degrees, and the lordotic angle increased from 14 to 19 degrees. A nd no significant changes was found in the last follow up. 16 cases (70%) showed the “excellent” and “good” clinical results and Simmons type II showed better clinical results than those of type I (type I was 9 cases and type II was 7 cases).
Conclusion
Patients with degenerative lumbar scoliosis with multiple spinal stenosis treated with wide total laminectomy and instrumentation by fixation of pedicle screw showed effects in coronal and sagittal balance, and considering instability resulting from involvements in multiple segments and other complex pathologic conditions seems to be important.
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Figures and Tables%
Fig. 1.
Simple X-ray of 41 year-old female with right lumbar scoliosis (34 degree of scoliotic curve, 12 degree of kyphotic curve). A. Preoperative and postoperative AP radiograph showed correction of lumbar scoliosis (15 degree). B. Preoperative and postoperative lateral radiograph showed restoration of lumbar lordosis (10 degree of lordotic curve). there were good maintenance at 12 months after operation.
Fig. 2.
Simple X-ray of 63 year-old male with left lumbar scoliosis (17 degree of scoliotic curve, 17 degree of scoliotic curve). A. Preoperative and postoperative AP radiograph showed correction of lumbar scoliosis (8 degree). B. Preoperative and postoperative lateral radiograph showed restoration of lumbar lordosis (18 degree). there were good maintenance at 12 months after operation.
Table 1.
Change of deformities in the preoperative and postoperative outcomes, respectively
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