The Study On The Outcomes Of Posterior Long-segment Fixation With Different Upper Iustrumented Vertebrae In Degenerative Lumbar Scoliosis

ObjectiveTo study the clinical outcomes of posterior long-segment fixation with different upper instrumented vertebrae for degenerative lumbar scoliosisMaterials and MethodsA retrospective study was conducted with medical records and the whole spine X-ray of degenerative lumbar scoliosis patients who underwent surgical correction from2008to2014in our hospital.30patients were enrolled in this research, including15cases in group A (the fusion from the upper thoracic spine above T10to L5or S1) and15cases in group B (the fusion from the upper thoracic spine below T10to L5or S1). results were stated as following:The operation time and the intraoperative bleeding amount, preoperative and postoperative Oswestry Disability Index (ODI), preoperative and postoperative lumbar lordosis (LL), preoperative and postoperative proximal junctional kyphosis (PJK), preoperative and postoperative sagittal vertical axis (SVA) preoperative and postoperative thoracic kyphosis (TK), preoperative and postoperative pelvic title(PT).ResultsThe preoperative main lumbar cobb angles of group A and group B were22.4±4.3°and22.5±9.6°which were significantly [P>0.01and P<0.01] corrected to4.1±1.5°nd4.2±5.2°with the correction of-18.1±3.8°and-18.2±4.0°[P=0.62]. The operation time [P<0..05] was longer and the intraoperative bleeding amount [P<0.05] was more in group A than that in group B. While there were not statistically signifiant differences between the2groups in postoperative Oswestry Disability Index (ODI)[P=0.15], postoperative thoracic kyphosis (TK)[P=0.68], postoperative proximal junctional kyphosis (PJK)[P=0.15], postoperative lumbar lordosis (LL)[P=0.45], postoperative sagittal vertical axis (SVA)[P=0.21] and postoperative pelvic title(PT)[P=0.58].ConclusionsFusion from the lower thoracic spine (below T10) is as effective as the fusion from the upper thoracic spine (above T10) in posterior long-segment fixation for degenerative lumbar scoliosis, with the advantages of shorter operation time and less blood loss. In addition spinal sagittal deformity correction can be improved.