Novel intervertebral space release for the treatment of moderate and severe degenerative scoliosis

. 2023 Jan 20;102(3):e32445.


doi: 10.1097/MD.0000000000032445.

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Hang Yuan et al.


Medicine (Baltimore).


.

Free PMC article

Abstract

To investigate the clinical effectiveness and feasibility of novel intervertebral space release without Smith-Petersen osteotomy/pedicle subtraction osteotomy/Ponte osteotomy in the treatment of adults with moderate to severe degenerative scoliosis. The data of 49 patients with moderate to severe degenerative scoliosis treated with a novel intervertebral space release and balance correction technique from January 2010 to January 2016 and followed up until January 2021 were collected based upon pre-designated inclusive and exclusive criteria for retrospective analyses. The Japanese Orthopaedic Association score and coronal Cobb angle were employed for the assessment of clinical symptoms and scoliosis correction improvements. Forty-nine patients were followed for a median time of 5.2 (1-11) years. The Japanese Orthopaedic Association score was significantly increased from 9.45 ± 3.33 preoperatively to 19.65 ± 4.58 postoperatively (P < .001), and the coronal Cobb angle was significantly improved from 39.95º ± 9.04º preoperatively to 8.28º ± 4.21º (P < .001) after 1 year. There were no major complications occurred in patients. The novel intervertebral space release and balance correction at the original lesion and maximal unbalance site without vertebral osteotomy showed a promising clinical profile and may be considered as an alternative for the treatment of moderate to severe degenerative scoliosis.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures


Figure 1.



Figure 1.

(A) The intervertebral space release only at the original lesion site and the maximal unbalance space; (B) insertion of pedicle screws; (C and D) vertebral rotation and scoliosis correction; (E–G) connection of the titanium alloy rod.


Figure 2.



Figure 2.

Original lesion sites and maximal unbalanced space in spines of adult patients with degenerative scoliosis. (A) Locations of the original lesion sites (yellow arrows). (B) Locations of the maximal unbalanced spaces (yellow arrows).


Figure 3.



Figure 3.

X-ray images of a 58-year old female lumbar scoliosis patient. Anterior-posterior images showing lumbar scoliosis (yellow arrows) (A) before and (B) after surgery. Lateral images (C) before and (D) after the intervention.

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