The Surgical Treatment of Nerve Root Compression Caused by Scoliosis of the Lumbar Spine

Martino, A San; D'Andria, F M; Martino, Celine

doi:10.1097/00007632-198304000-00005

Cited by 30 publications

(21 citation statements)

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“…[5][6][7][8][11][12][13]32,45,49,[69][70][71] Loss of regional lordosis (development of lumbar kyphosis) results in progressive sagittal imbalance. 11,61,62,64,72 Loss of lumbar lordosis and progressive rotatory olisthesis tends to increase the intensity of low-back pain, suggesting that both of these factors must be targeted in the treatment of degenerative lumbar scoliosis.…”

Section: Discussionmentioning

confidence: 99%

Less Invasive Surgical Correction of Adult Degenerative Scoliosis. Part II: Complications and Clinical Outcome

et al. 2010

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Less invasive image-guided correction of degenerative scoliosis in elderly patients with significant comorbidity yields a favorable complication profile. Significant improvements in spinal balance, pain, and functional scores mirrored expedited ambulation and early resumption of daily activities. Less invasive techniques appear suitable to reduce periprocedural morbidity, especially in elderly patients and individuals with significant medical risk factors.

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Section: Discussionmentioning

confidence: 99%

Less Invasive Surgical Correction of Adult Degenerative Scoliosis. Part II: Complications and Clinical Outcome

et al. 2010

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“…44 These results were further supported by San Martino et al in a study of 20 patients with DLS undergoing laminectomy with no fusion. 43 There were no reoperations needed and all patients experienced relief of their chief complaint, with restoration of function following decompression. 43 Within several studies, minimally invasive and conservative techniques demonstrated lower complication rates compared with matched open fusion cohorts.…”

mentioning

confidence: 89%

“…43 There were no reoperations needed and all patients experienced relief of their chief complaint, with restoration of function following decompression. 43 Within several studies, minimally invasive and conservative techniques demonstrated lower complication rates compared with matched open fusion cohorts. 35,46 Transfeldt and colleagues conducted a study including 85 patients, 21 of whom underwent decompression alone.…”

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confidence: 89%

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Minimally invasive spine surgery for adult degenerative lumbar scoliosis

Dangelmajer

Zadnik

Rodríguez

et al. 2014

FOC

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Object Historically, adult degenerative lumbar scoliosis (DLS) has been treated with multilevel decompression and instrumented fusion to reduce neural compression and stabilize the spinal column. However, due to the profound morbidity associated with complex multilevel surgery, particularly in elderly patients and those with multiple medical comorbidities, minimally invasive surgical approaches have been proposed. The goal of this meta-analysis was to review the differences in patient selection for minimally invasive surgical versus open surgical procedures for adult DLS, and to compare the postoperative outcomes following minimally invasive surgery (MIS) and open surgery. Methods In this meta-analysis the authors analyzed the complication rates and the clinical outcomes for patients with adult DLS undergoing complex decompressive procedures with fusion versus minimally invasive surgical approaches. Minimally invasive surgical approaches included decompressive laminectomy, microscopic decompression, lateral and extreme lateral interbody fusion (XLIF), and percutaneous pedicle screw placement for fusion. Mean patient age, complication rates, reoperation rates, Cobb angle, and measures of sagittal balance were investigated and compared between groups. Results Twelve studies were identified for comparison in the MIS group, with 8 studies describing the lateral interbody fusion or XLIF and 4 studies describing decompression without fusion. In the decompression MIS group, the mean preoperative Cobb angle was 16.7° and mean postoperative Cobb angle was 18°. In the XLIF group, mean pre- and postoperative Cobb angles were 22.3° and 9.2°, respectively. The difference in postoperative Cobb angle was statistically significant between groups on 1-way ANOVA (p = 0.014). Mean preoperative Cobb angle, mean patient age, and complication rate did not differ between the XLIF and decompression groups. Thirty-five studies were identified for inclusion in the open surgery group, with 18 studies describing patients with open fusion without osteotomy and 17 papers detailing outcomes after open fusion with osteotomy. Mean preoperative curve in the open fusion without osteotomy and with osteotomy groups was 41.3° and 32°, respectively. Mean reoperation rate was significantly higher in the osteotomy group (p = 0.008). On 1-way ANOVA comparing all groups, there was a statistically significant difference in mean age (p = 0.004) and mean preoperative curve (p = 0.002). There was no statistically significant difference in complication rates between groups (p = 0.28). Conclusions The results of this study suggest that surgeons are offering patients open surgery or MIS depending on their age and the severity of their deformity. Greater sagittal and coronal correction was noted in the XLIF versus decompression only MIS groups. Larger Cobb angles, greater sagittal imbalance, and higher reoperation rates were found in studies reporting the use of open fusion with osteotomy. Although complication rates did not significantly differ between groups, these data are difficult to interpret given the heterogeneity in reporting complications between studies.

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“…The coexistence of spinal stenosis and scoliosis in the lumbar spine is becoming a more frequent problem in the elderly population [13,14]. Scoliosis is often progressive and associated with significant back pain.…”

Section: Discussionmentioning

confidence: 99%

Beneficial effects following microsurgical decompression in an adult with congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele: an interesting case report

Ghani

Kroeber

2012

Arch Orthop Trauma Surg

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The Surgical Treatment of Nerve Root Compression Caused by Scoliosis of the Lumbar Spine

Cited by 30 publications

References 0 publications

Less Invasive Surgical Correction of Adult Degenerative Scoliosis. Part II: Complications and Clinical Outcome

Less Invasive Surgical Correction of Adult Degenerative Scoliosis. Part II: Complications and Clinical Outcome

Minimally invasive spine surgery for adult degenerative lumbar scoliosis

Beneficial effects following microsurgical decompression in an adult with congenital thoraco-lumbar kyphoscoliosis with spina bifida aperta and myelomeningocele: an interesting case report

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