Short-term Clinical Curative Effect Evaluation Of Long Segmental Fixation And Fusion Surgery Treatment For Adult Degenerative Scoliosis

Objective:Evaluating the short-term clinical effect of long segmental fixation fusion surgery for adult degenerative scoliosis(ADS);to explore a more proper treatment for ADS.Methods:Comparing and analyzing the records of twenty-nine patients who had spine surgeries of ADS in Jiangxi Province People's Hospital during January 2012 and June 2016.Before the surgeries,lateral cobb angle?lumbar lordosis angle were measured and the VAS score?JOA score?ODI index were recorded according to the patients' preoperative spinal lateral side X-ray photographs.After the posterior pedicle screw internal fixation surgeries and sufficient decompression during surgeries,the operation time,bleeding volume,surgical complications were recorded.One week later of the surgeries,lateral cobb angle?lumbar lordosis angle?VAS score? JOA score?ODI index were recorded for a second time.Patients were required to come back to hospital to take regularly review on the spinal lateral side X-ray photographs.Three months later,measuring the lateral cobb angle?lumbar lordosis angle and recording VAS score?JOA score?ODI index.Comparing these records for a statistical analysis.Results:The backache of twenty-nine patients were successfully relieved and quality of life has been improved.After the operation,the pain of radiating to lower limbs and lameness was reduced.However,three patients still felt numbness of the lower limbs.Two patients suffered from postoperative incision exudate that failed with the anti-infection treatment.With a consideration of bone allograft rejection,the two patients had surgical debridement to probe again to remove the allogeneic bone.After the debridement surgeries,the incision healed well.Only one patient suffered from endorhachis damaged in the operation,had to endorhachis in the operation.One patient suffered the transient dyspnea in a few days after the surgery,and had given a relevant department consultation to improve the pulmonary artery angiography which was considered as the terminal branch of the branch of pulmonary artery embolism.After the treatment,the patients recovered well.Three patients suffered from pulmonary infection improved markedly after anti-infection.Comparing the data before the surgeries with the data one week later after the surgeries,we can make a conclusion that the lateral cobb Angle,lumbar lordosis Angle were obviously corrected(P < 0.05);VAS scores,JOA score and ODI index improved significantly(P < 0.05).Further more,comparing the data one week later after the surgeries with the data three months later after the surgeries,we can conclude that the lateral cobb Angle had mild loss(P < 0.05),lumbar lordosis Angle had no obvious change(P > 0.05);VAS score,JOA score and ODI index were improved significantly(P < 0.05).Conclusions:Long segmental fixation surgery can obviously restore the sagittal and coronal balance of the spine for the patients suffered from large lateral bending Angle and severe dysfunction of ADS.This treatment also could reduce low back pain and improve the function of lower limbs.Long segment fixation fusion surgery in the treatment of scoliosis is safe and effective.