Posterior column osteotomy plus unilateral cage strutting for correction of lumbosacral fractional curve in degenerative lumbar scoliosis
Autor: | Shuai Jiang, Zhuoran Sun, Hui Wang, Longjie Wang, Weishi Li |
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Rok vydání: | 2020 |
Předmět: |
Male
lcsh:Diseases of the musculoskeletal system medicine.medical_treatment Osteotomy 03 medical and health sciences 0302 clinical medicine lcsh:Orthopedic surgery Technical Note medicine Humans Degenerative lumbar scoliosis Orthopedics and Sports Medicine Aged Retrospective Studies 030222 orthopedics Lumbar Vertebrae Cobb angle business.industry Lumbosacral Region Posterior column osteotomy Lumbosacral fractional curve Unilateral cage strutting Middle Aged Plastic Surgery Procedures Posterior column Sagittal plane Oswestry Disability Index lcsh:RD701-811 Spinal Fusion medicine.anatomical_structure Scoliosis Coronal plane Female Surgery lcsh:RC925-935 Nuclear medicine business 030217 neurology & neurosurgery Lumbosacral joint Lumbosacral lordotic angle |
Zdroj: | Journal of Orthopaedic Surgery and Research Journal of Orthopaedic Surgery and Research, Vol 15, Iss 1, Pp 1-8 (2020) |
ISSN: | 1749-799X |
DOI: | 10.1186/s13018-020-02011-y |
Popis: | Background Inadequate release of the posterior spinal bone elements may hinder the correction of the lumbosacral fractional curve in degenerative lumbar scoliosis, since the lumbosacral junction tends to be particularly rigid and may already be fused into an abnormal position. The purpose of this study was to evaluate the surgical outcome and complications of posterior column osteotomy plus unilateral cage strutting technique on lumbosacral concavity for correction of fractional curve in degenerative lumbar scoliosis patients. Methods Thirty-two degenerative lumbar scoliosis patients with lumbosacral fractional curve more than 15° that were surgically treated by posterior column osteotomy plus unilateral cage strutting technique were retrospectively reviewed. The patients’ medical records were reviewed to identify demographic and surgical data, including age, sex, body mass index, back pain, leg pain, Oswestry Disability Index, operation time, blood loss, and instrumentation levels. Radiological data including coronal balance distance, Cobb angle, lumbosacral coronal angle, sagittal vertical axis, lumbar lordosis, and lumbosacral lordotic angle were evaluated before and after surgery. Cage subsidence and bone fusion were evaluated at 2-year follow-up. Results All patients underwent the operation successfully; lumbosacral coronal angle changed from preoperative 20.1 ± 5.3° to postoperative 5.8 ± 5.7°, with mean correction of 14.3 ± 4.4°, and the correction was maintained at 2-year follow-up. Cobb’s angle and coronal balance distance decreased from preoperative to postoperative; the correction was maintained at 2-year follow-up. Sagittal vertical axis decreased, and lumbar lordosis increased from preoperative to postoperative; the correction was also maintained at 2-year follow-up. Lumbosacral lordotic angle presented no change from preoperative to postoperative and from postoperative to 2-year follow-up. Postoperatively, there were 8 patients with lumbosacral coronal angle more than 10°, they got the similar lumbosacral coronal angle correction, but presented larger preoperative Cobb and lumbosacral coronal angle than the other 24 patients. No cage subsidence was detected; all patients achieved intervertebral bone fusion and inter-transverse bone graft fusion at the lumbosacral region at 2-year follow-up. Conclusion Posterior column osteotomy plus unilateral cage strutting technique on the lumbosacral concavity facilitate effective correction of the fractional curve in degenerative lumbar scoliosis patients through complete release of dural sac as well as the asymmetrical intervertebral reconstruction by cage. |
Databáze: | OpenAIRE |
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