Clinical and radiological outcomes after decompression and posterior fusion in patients with degenerative scoliosis

Abstract

Objective: The prevalence of degenerative scoliosis (DS) increases with age and an overall increase is seen due to the aging population. This study aims to evaluate the clinical and radiological outcomes after decompression and posterior fusion in patients with DS.

Methods: In this is prospective study, 43 patients with DS, aged 37 to 70 years, were eligible to undergo decompression and posterior fusion. Primary outcomes were low back pain (LBP) with or without radicular pain, which was evaluated preoperatively and at 12 and 24 months after surgery with the use of a visual analog scale (VAS), and the quality of life (QOL), which was assessed at the same time periods by the Oswestry Disability Index (ODI) questionnaire. The Cobb's method was used to measure the degree of scoliosis in each patient preoperatively and at 24 hours, 12 and 24 months after the surgery.

Results: VAS scores improved significantly from a mean of 8.18 preoperatively to 4.48 at 12 months and 3.07 at 24 months postoperatively (P < .001). The mean radicular pain scores also decreased significantly (P < .001). At postoperative 12 months, the mean ODI score was significantly lower than the mean preoperative ODI score (47.81 ± 16.06 vs. 72.18 ± 12.28; P = .001). ODI score at 24 months postoperatively was significantly better than the preoperative ODI (15.53 ± 7.21 vs. 72.18 ± 12.28; P = .016). The mean Cobb angle changed significantly from 31.4° ± 4.88 preoperatively to 3.28° ± 2.10 at 24 months postoperatively (P < .001).

Conclusions: Our findings suggest that decompression and posterior fusion in the patients with DS is an effective surgical method which is associated with satisfying clinical results in terms of improvement of postoperative LBP, radicular pain, and QOL, and correction of Cobb angle at 12 and 24 months after the surgery and restoration of sagittal alignment at 2 months postoperatively.

Keywords:

• Degenerative scoliosis
• low back pain
• functional quality of life
• cobb angle
• sagittal deformity
• modic changes

Acknowledgements

The present article was extracted from the thesis written by Dr. M. Jamali in Neurosurgery and was supported by Shiraz University of Medical Sciences (Grant No. 2427).

Disclosure statement

The authors have no conflicts of interest and no source of funding. It was financially supported by the Vice-Chancellor for Research Affairs of Shiraz University of Medical Sciences (Grant No. 2427), but they had no role in the design of the trial, the collection or analysis of data, preparation of the manuscript, or the decision to submit it for publication.

Additional information

Funding

The present article was extracted from the thesis written by Dr. M. Jamali in Neurosurgery and was supported by Shiraz University of Medical Sciences, Shiraz, Iran [Grant No. 2427].