Osteotomy Approach Of Surgery In Adult Fixed Degenerative Spine Scoliosis

Objective:To investigate the radiographic features and surgical osteotomy approach of adult fixed degenerative spine scoliosis. Methods:We Collected 45 cases of adult fixed degenerative spine scoliosis following by long segmental fixed orthopedic in our hospital from January 2011 to September 2014 retrospectively, in which 28 cases of SPO and 17 of PSO.SPO group were 8 males and 20 females with an average age of 61.1 years, including 17 cases of angiocardiopathy,5 cases of disease of respiratory system and 11 cases of diabetes. PSO group were 6 males and 11 females with an average age of 62.5 years, including 6 cases of angiocardiopathy,3 cases of disease of respiratory system and 7 cases of diabetes. We selected the osteotomy approach by means of CT scans which assess the sites of the spine deformity, analyzing the result of radiography and efficacy in pre-operation and last-follow of two group. Results:Surgical treatment of 45 patients were successfully completed with no death. All patients were followed up for an average period of 22.4 months postoperatively. ODI and VAS of all last-follow were superior than that of pre-operation, which were also statistically significant (P<0.05). The improvement rate of Cobb angle was 69.33% in SPO group, and was 76.14% in PSO group.The two group restored the coronal and sagittal balance of spine, and the two osteotomy approach obtained good clinical efficacies.The average time of operation was 213 minutes, and the average blood loss was 1253 ml in SPO group, which included 5 cases of cerebrospinal leak,1 case of infection and 1 case of internal fixation loosening. The average time of operation was 264 minutes, and the average blood loss was 1756 ml in PSO group, which included 4 cases of cerebrospinal leak,1 case of infection and nothing of internal fixation loosening. Conclusion:The choice of surgical osteotomy approach of adult fixed degenerative spine scoliosis is according to the pre-operation imaging information, including local angular deformity, lumbar kyphosis, intervertebral disc ossification, facet fusion and sagittal imbalance.SPO may settle the orthopedic problem of degenerative spine scoliosis, but servere degenerative spine scoliosis need to use PSO. The two osteotomy approach obtained good clinical efficacies.