Pedicle Fixation Devices in the Treatment of Adult Lumbar Scoliosis

Publisher Website
Google Scholar
Abstract
Segmental pedicle screw instrumentation in adult tumbar scoliosis allows better curve correction and restoration of lumbar lordosis. In a retrospective study, to assess the value of this fixation, 9 patients treated with the AO Internal Fixator and 18 with Cotrel-Oubousset instrumentation were reviewed. Mean age at surgery was 60 years (range, 40–88), and curves were measured between 22° and 82°. At follow-up (mean of 56 months for the AO Internal Fixator and 42 months for Cotrel-Dubousset instrumentation), the average curve correction was better than 50%. Overall satisfactory clinical results with pain relief and improved walking distance were noted in 86% of the patients. Using this technique no postoperative deaths or neurologic deficits occurred. Only a few complications and a 4% pseudarthrosis rate could be observed. Our study shows that the age of the patients with degenerative scoliosis is not a contraindication for major surgery. Meticulous posterior spine release before instrumentation is essential for curve correction and bone fusion. Lumbar lordosis is more easily restored with Cotrel-Dubousset instrumentation, which seems to correspond to the incidence of low back pain. Cases with evident neurologic deficits are best treated by additional nerve decompression.

This publication has 0 references indexed in Scilit: