The Clinical Analysis Of Different Segment Instrumental Fusion Methods For Degenerative Lumbar Scoliosis

Objective:To investigate the clinical efficacy of lumbar posterior decompression and fixation and fusion in treatment of degenerative lumbar scoliosis,and to compare different surgical options which may contribute to the outcome.Methods:Retrospectively collect and analysis the clinical data of 39 patients who underwent operations for degenerative lumbar scoliosis in the second hospital of Jilin university during 2013.2 to 2017.7.According to the range of fusion,these patients were divided into short segment group and long segment group,which underwent posterior decompression and short segment fixation and fusion group(2.3±1.1)in15 cases;posterior decompression long segment fixation and fusion group(5.4±1.3)in 24 cases.The Cobb’s angles were measured to assess the lumbar scoliosis and kyphosis.The clinical and radiographic outcomes,including surgery time,blooding and surgery complications were compared between two groups.Respectively JOA and ODI was used to evaluate the clinical effects before and after the surgery.Further,the clinical parameters of all patients were fetched by SPSS19.0 statistical software(a=0.05)to predict the market,and analysis and evaluation of the difference and effect of selection conditions of these two groups of different fixation fusion for degenerative lumbar scoliosis.Results:The clinical information of all patients were compared and analysis,and clinical improvement was observed in all the patients andeffect was satisfactory.The JOA and ODI score of patients got significant improvement.The blooding and surgery time of long segment group was significantly more than that short segment group(P<0.05);By contrasting JOA and ODI data,There was no significant difference in improve clinical symptoms between short segment group and long segment group.Before surgery,the average Cobb angle was 18.2±3.49°in the short fusion group and 30.45±6.32°in the long fusion group.At the last follow up was 10.11±1.6°and 11.4±1.95°,respectively.The mean correction rate of Cobb’s angle was62.5±6.17%(long segment group)and 44.45±2.55%(short segment group),respectively.The correction rate of two groups had significant difference(P<0.05).The lumbar lordosis angles of the preoperative was19.44±6.55 °(long segment group)and 21.67±3.01 °(short segment group),and improved to 29.3±3.81 °(long segment group)and30.25±4.7°(short segment group)at final follow-up.The correction rate of two groups had no significant difference(P>0.05).Condusion:The posterior decompression and instrumental fusion is an effective therapy for degenerative lumbar scoliosis.Although the scoliosis correction rate of long-segment fixation group is higher,it causes a higher complication rate and increased surgery time and blooding.So,in the choice of surgical approach should rigorous analysis the clinical and radiographic outcomes,then make reasonable operation strategy.