Posterior Orthopedic Fusion Alone Treatment Of Degenerative Neurological Symptoms Associated With Adult Idiopathic Scoliosis Clinical Research

Research background:Adult idiopathic scoliosis is adolescent idiopathic pre-existing scoliosis, and continuing through adult, adolescent idiopathic scoliosis into adulthood is not static, but with increasing age, side convex deformity further progress, resulting in spinal stenosis, after sudden increase in spinal decompensation, is back pain, nerve root pain, asymmetric shape and the root causes of heart and lung function decline. Adult idiopathic scoliosis in adults have a higher prevalence.With degeneration of adult idiopathic scoliosis often accompanied with low back pain and lower limb neurological symptoms, even paralysis, to a patient suffering greatly, seriously affecting the quality of life. When conservative treatment is difficult to obtain relief, the majority of patients need surgery. The selection of surgical method is controversial,most reported in the literature require spinal decompression, orthopedic and fusion surgery, surgical risk and trauma of spinal decompression surgery to increase, the elderly is difficult to tolerate.Spinal decompression surgery could not be reached for palliation of symptoms,improve quality of life purpose there is not reported in the literature.Research purposes:Through posterior fusion orthopedic alone surgical treatment of adults with degenerative idiopathic scoliosis results of analysis of fusion for the treatment of simple orthopedic degeneration with adult idiopathic scoliosis safety and effectiveness, and constraints.Methods:Our department from June 2003 to March 2009 a total of surgical treatment of 65 cases with adult idiopathic scoliosis in which the degeneration associated with adult idiopathic scoliosis in 38 cases.Of which 24 cases posterior pedicle screw alone orthopedic fixation, Posterolateral fusion. After discharge from hospital on a regular basis (3,6,12 months,each subsequent annual) review, analysis before and after operation, the last follow-up plain film, The clinical performance of the fusion and deformity correction of the situation. Preoperative VAS and ODI score, and postoperative and follow-up after 1 year when compared.Result:24 patients operation time 130～310min, an average of 159±43min. Bleeding 560m1～2800ml, an average of 1204±464ml.Were followed up for an average of 35 months(15 to 73 months).Were no perioperative wound infection. There were no broken nails, broken rods, no junctional kyphosis.Before surgery,and after 1 year follow-up VAS and ODI score when, statistics show that cases 1 year after surgery and postoperative follow-up, VAS and ODI score and preoperative significant difference.(P <0.05).Conclusion:Posterior orthopedic fusion alone treatment of adults with degenerative idiopathic scoliosis is effective.Posterior fusion alone with orthopedic surgery have a short time, less bleeding, lower the incidence of complications, etc.but such operations have certain restrictive and does not apply to all associated with degeneration of adult idiopathic scoliosis.