Clinical Outcome And Analysis Of Lenke-Silva Classification For The Treatment Of Degenerative Lumbar Scoliosis

Objective: To evaluate the clinical application and it's significance of Lenke-silva classification in the treatment of degenerative lumbar scoliosis.Methods: Sixty five patients who underwent spinal surgery in our hospital from March 2011 to September 2014 were included in this retrospective study. According to the Lenke-Silva classification, there were respective 7 case,14 case,15 case,13 case,10 case,6 case from grade one to six. there are different selection of operation in different grade. As follow: Grade one: Decompression alone(n=7); Grade two: Decompression with short segment fusion fixation(n=14); Grade three: Decompression and short segment fusion fixation(n=3), The correction of scoliosis curvature and short segment fusion fixation(n=12); Grade four: Decompression and the restoration of lumbar lordosis(n=10), Extending the fusion and instrumentation into the thoracic region(n=3); Grade five: Extending the fusion and instrumentation into the thoracic region(n=9), osteotomy(n=1); Grade six: Osteotomy(n=6). The sagittal vertical axis(SVA), the distance from C7 plumb line to central sacral vertical line distance(C7PL-CSVL), lumbar Cobb angle, lumbar lordosis(LL), pelvic tilt(PT), pelvic incidence(PI), the matched degree between pelvic incidence and lumbar lordosis(PI-LL) were compared before and after operation; To compare the score result of visual analogue scale, Oswestry score(ODI), scoliosis research society-22(SRS-22) before and after operation.Results: All patients had the followship, the shortest for eleven monthes and the longest for four years, the average for fifteen point three monthes. The comprasion of socore of VAS ODI SRS-22 between pre-operation and post-operation have the marked improvement(P<0.05); no significant difference was observed in PI; Grade one and two: no significant difference was observed in lumbar Cobb angle, lumbar lordosis(LL), pelvic tilt(PT), the matched degree between pelvic incidence and lumbar lordosis(PI-LL) before and after operation(P>0.05); Grade three to six: PI exceped, there were observed significant difference in all imaging parameters(P<0.05).Conclusion: All the surgical plan for the degenerative lumbar scoliosis are based on Lenke-silva classification and they all get the favourable clicical outcome. This classification have exactly clinical guiding significanc, feasilities in clinical practice and notable practicality to guide the diagnosis and treatment of degenerative scoliosis for our country people. It give a reliable information to the decision of treatment and can be a clinical classification of degenerateive lumbar scoliosis in our country..