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Published in: European Spine Journal 6/2013

01-11-2013 | Original Article

Surgical treatment of adult degenerative scoliosis

Authors: Matteo Palmisani, Eugen Dema, Stefano Cervellati

Published in: European Spine Journal | Special Issue 6/2013

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Abstract

Introduction

The surgical treatment of adult scoliosis still presents many points of discussion. Decision-making on the type of treatment is mandatory to evaluate all the possible alternatives to surgery.

Materials and methods

From January 2000 to December 2008, 49 cases of adult degenerative scoliosis and kyphoscoliosis were surgically treated. Thirty-six patients were monitored for a mean of 8 years (5–10). There were 10 males and 26 females, with a mean age of 66 years (55–80). Arthrodesis was carried out using pedicle screws at all levels extending to the sacrum in 30 cases and to the ileum in 4. Laminectomy was performed in 20 cases, radicular liberation in 15, PLIF in 10.

Results

After an average term of 8 years (5–10) we record 8 (23 %) excellent cases, 10 (29 %) good, 12 (34 %) satisfactory, 5 (14 %) bad. The VAS in the pre-operative period had a value of 7 (5–9) passed in the post-operative period of 3 (0–6). 13 reoperations were performed (36 %).
Literature
2.
go back to reference Kostuick JP, Bentivoglio J (1981) The incidence of low-back pain in adult scoliosis. Spine 6:268–273CrossRef Kostuick JP, Bentivoglio J (1981) The incidence of low-back pain in adult scoliosis. Spine 6:268–273CrossRef
3.
go back to reference Perennou D, Marcelli C, Héricson C, Simon L (1994) Adult lumbar scoliosis. Epidemiological aspects in a low back pain population. Spine 19:123–128PubMedCrossRef Perennou D, Marcelli C, Héricson C, Simon L (1994) Adult lumbar scoliosis. Epidemiological aspects in a low back pain population. Spine 19:123–128PubMedCrossRef
4.
go back to reference Jimbo S, Kobayashi T, Aono K, Atsuta Y, Matsumo T (2012) Epidemiology of degenerative lumbar scoliosis: community based cohort study. Spine 37:1763–1770PubMedCrossRef Jimbo S, Kobayashi T, Aono K, Atsuta Y, Matsumo T (2012) Epidemiology of degenerative lumbar scoliosis: community based cohort study. Spine 37:1763–1770PubMedCrossRef
5.
go back to reference Robin GC, Span Y, Steinberg R, Makin M, Menczel J (1982) Scoliosis in elderly: a follow-up study. Spine 7:355–359PubMedCrossRef Robin GC, Span Y, Steinberg R, Makin M, Menczel J (1982) Scoliosis in elderly: a follow-up study. Spine 7:355–359PubMedCrossRef
6.
go back to reference Vanderpool DW, James JI, Wynne-Davies R (1969) Scoliosis in elderly. J Bone Joint Surg Am 51:446–455PubMed Vanderpool DW, James JI, Wynne-Davies R (1969) Scoliosis in elderly. J Bone Joint Surg Am 51:446–455PubMed
9.
go back to reference Seo JY, Hwang TH, Kim KW, Kim YH (2011) Risk of progression of degenerative lumbar scoliosis. J Neurosurg Spine 15:558–566PubMedCrossRef Seo JY, Hwang TH, Kim KW, Kim YH (2011) Risk of progression of degenerative lumbar scoliosis. J Neurosurg Spine 15:558–566PubMedCrossRef
10.
go back to reference Bradford DS, Tay BK, Hu SS (1999) Adult scoliosis: surgical indications. Operative management, complications and outcome. Spine 24:2617–2629PubMedCrossRef Bradford DS, Tay BK, Hu SS (1999) Adult scoliosis: surgical indications. Operative management, complications and outcome. Spine 24:2617–2629PubMedCrossRef
11.
go back to reference Jackson RP, Simmons EH, Stripinis D (1983) Incidence and severity of back pain in adult idiopathic scoliosis. Spine 8:749–756PubMedCrossRef Jackson RP, Simmons EH, Stripinis D (1983) Incidence and severity of back pain in adult idiopathic scoliosis. Spine 8:749–756PubMedCrossRef
12.
go back to reference Schwab FJ, Smith VA, Biserni M, Gamez L, Farcy JP, Pagala M (2002) Adult scoliosis. A quantitative radiographic and clinical analysis. Spine 27:387–392PubMedCrossRef Schwab FJ, Smith VA, Biserni M, Gamez L, Farcy JP, Pagala M (2002) Adult scoliosis. A quantitative radiographic and clinical analysis. Spine 27:387–392PubMedCrossRef
13.
go back to reference Glassman SD, Schwab FJ, Bridwell Kh, Ondra SL, Breven S, Lenke LG (2007) The selection of operative versus nonoperative treatment in patients with adult scoliosis. Spine 32:93–97PubMedCrossRef Glassman SD, Schwab FJ, Bridwell Kh, Ondra SL, Breven S, Lenke LG (2007) The selection of operative versus nonoperative treatment in patients with adult scoliosis. Spine 32:93–97PubMedCrossRef
14.
go back to reference Bridwell KH, Berven S, Eduards CII et al (2007) The problems and limitations of applying evidence-based medicine to primary surgical treatment of adult spinal deformity. Spine 32:S135–S139PubMedCrossRef Bridwell KH, Berven S, Eduards CII et al (2007) The problems and limitations of applying evidence-based medicine to primary surgical treatment of adult spinal deformity. Spine 32:S135–S139PubMedCrossRef
15.
go back to reference Daubs KD, Lenke LG, Chen G, Stobbs G, Bridwell KH (2007) Adult spinal deformity surgery. Complications and outcomes in patients over age 60. Spine 32:2238–2244PubMedCrossRef Daubs KD, Lenke LG, Chen G, Stobbs G, Bridwell KH (2007) Adult spinal deformity surgery. Complications and outcomes in patients over age 60. Spine 32:2238–2244PubMedCrossRef
16.
go back to reference Cho KJ, Suk S-II, Park SR, Kim JH, Kim SS, Choi WK, Lee KY, Lee SR (2007) Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis. Spine 32:2232–2237PubMedCrossRef Cho KJ, Suk S-II, Park SR, Kim JH, Kim SS, Choi WK, Lee KY, Lee SR (2007) Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis. Spine 32:2232–2237PubMedCrossRef
17.
go back to reference Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D, Study Group on Scoliosis (2012) Cpmplications and risk factors of primary adult scoliosis surgery: a multicentre study of 306 patients. Spine 37:693–700PubMedCrossRef Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D, Study Group on Scoliosis (2012) Cpmplications and risk factors of primary adult scoliosis surgery: a multicentre study of 306 patients. Spine 37:693–700PubMedCrossRef
18.
go back to reference Sansur CA, Smith JS, Coe JD, Glassman SD, Breven SH, Polly DW Jr, Perra JH, Boachie-Adjei O, Schaffrey CL (2011) Scoliosi research society morbility and mortality of adult scoliosis surgery. Spine 36:E593–E597PubMedCrossRef Sansur CA, Smith JS, Coe JD, Glassman SD, Breven SH, Polly DW Jr, Perra JH, Boachie-Adjei O, Schaffrey CL (2011) Scoliosi research society morbility and mortality of adult scoliosis surgery. Spine 36:E593–E597PubMedCrossRef
19.
go back to reference O’Shaughnessy BA, Bridwell KH, Lenke LG, Cho W, Baldus C, Chang MS, Auerbach JD, Crawford CH (2012) Does a long fusion “T3-sacrum” ported a worse outcome than fusion “T10-sacrum” in primary surgery for adult scoliosis? Spine 37:884–890PubMedCrossRef O’Shaughnessy BA, Bridwell KH, Lenke LG, Cho W, Baldus C, Chang MS, Auerbach JD, Crawford CH (2012) Does a long fusion “T3-sacrum” ported a worse outcome than fusion “T10-sacrum” in primary surgery for adult scoliosis? Spine 37:884–890PubMedCrossRef
20.
go back to reference Kim YJ, Bridewll KH, Lenke LG, Rhim SR, Chen G (2006) Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum: prevalence and risk factor analysis of the 144 cases. Spine 31:2329–2336PubMedCrossRef Kim YJ, Bridewll KH, Lenke LG, Rhim SR, Chen G (2006) Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum: prevalence and risk factor analysis of the 144 cases. Spine 31:2329–2336PubMedCrossRef
21.
go back to reference White AH, von Rogov P, Zucherman J, Heiden D (1987) Lumbar laminectomy for herniated disc: a prospective controlled comparison with internal fusion. Spine 12:3057 White AH, von Rogov P, Zucherman J, Heiden D (1987) Lumbar laminectomy for herniated disc: a prospective controlled comparison with internal fusion. Spine 12:3057
22.
go back to reference O’shaughnessy BA, Lenke LG, Bridwell KH, Cho W, Zebala LP, Chang MS, Auerbach JD, Crawford CH, Koester LA (2012) Should symptomatic iliac screw be electively removed in adult spinal deformity patients fused to the sacrum? Spine 37:1175–1181PubMedCrossRef O’shaughnessy BA, Lenke LG, Bridwell KH, Cho W, Zebala LP, Chang MS, Auerbach JD, Crawford CH, Koester LA (2012) Should symptomatic iliac screw be electively removed in adult spinal deformity patients fused to the sacrum? Spine 37:1175–1181PubMedCrossRef
23.
go back to reference Cho KJ, Suk S-II, Park SR, Kim JH, Choi SW, Yoon YH, Won MH (2009) Arthrodesis to L5 versus S1 in long instrumentation and fusion for degenerative scoliosis. Eur Spine J 18:531–537PubMedCrossRef Cho KJ, Suk S-II, Park SR, Kim JH, Choi SW, Yoon YH, Won MH (2009) Arthrodesis to L5 versus S1 in long instrumentation and fusion for degenerative scoliosis. Eur Spine J 18:531–537PubMedCrossRef
Metadata
Title
Surgical treatment of adult degenerative scoliosis
Authors
Matteo Palmisani
Eugen Dema
Stefano Cervellati
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 6/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-3012-1

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