Artikel
Lumbar spinal stenosis in degenerative scoliosis
Suche in Medline nach
Autoren
Veröffentlicht: | 13. Juni 2005 |
---|
Gliederung
Text
Introduction
Degenerative scoliosis is one of the most common reasons for lumbar spinal stenosis. The operative treatment is a challenge for spine surgery and it puts high demands in spinal implants. The spinal stenosis in degenerative scoliosis is a combination of deformity and instability on one hand and segmental stenosis due to degenerative disc and facet joint diseases on the other. Therefore surgery has to take both in account. The operation must be a combination between decompression surgery and reduction of the spinal deformity. Decompression surgeries alone can lead to more instability and deformation and enhance the symptoms of spinal stenosis.
Methods
Within the last 4 Years 58 patients with degenerative scoliosis and spinal stenosis were operated. Average age 74,2 Years. All of them had symptoms of spinal stenosis, such as neurogenic claudication, with a decrease in walking distance. Low back pain was not always present. 45 patients underwent a posterior surgery only (posterolateral intertransversal fusion). In 12 cases combined posterior-anterior surgery was performed. Indications for posterolateral fusions were flexible scoliosis without significant kyphosis. Indications for anterior-posterior fusions were rigid scoliosis or kyphosis of the lumbar spine.
Results
All patients benefit from surgery. Pain score (0-10 visual analog scale) improved from 7,3 to 3,2 and the average waking distance increased from 200m to 2000m (12 months postop.). Complications: 5 dura violations were documented. 1 patient developed a deep wound infection and 1 a pseudarthrosis. No implant related complications were seen.
Conclusions
Consequent reduction of spinal deformity and selective decompression surgery lead to good clinical results in the treatment of spinal stenosis in degenerative scoliosis.