J Korean Soc Spine Surg.  2007 Dec;14(4):278-286.

Selective Pedicle Screw Fixation with Long Fusion in the Treatment of Spinal Stenosis with Degenerative Scoliosis

• Choi JY
• Shin HK
• Jung HJ
• Kim JM
• Kim GS
• Kang DH

Abstract

STUDY DESIGN: This retrospective study was designed to evaluate treatment options for spinal stenosis with degenerative scoliosis. PURPOSE: To evaluate the clinical outcomes based on the degree of spinal deformity for selective pedicle screw fixation with a long fusion for spinal stenosis with degenerative scoliosis.
MATERIALS AND METHODS
We reviewed 54 cases performed from March 1996 to March 2006, and divided them into three groups based on osteophyte formation, pedicular rotation, and lateral transition. The three groups were analyzed for degree of correction of scoliotic and lordotic angle and bone fusion rate, as well as radiographically and clinically using the Kirkaldy-Willis questionnaire.
RESULTS
Mild or moderate deformities (49 cases) were improved an average of 3 degrees of scoliotic angle, grade 1 of pedicular rotation, and 1 mm of lateral transition and were satisfied clinically. Severe deformities (5 cases) improved an average of 8 degrees of scoliotic angle, grade 2 of pedicular rotation, and 3 mm of lateral transition, but were clinically unsatisfactory. There was insignificant correction of the lordotic angle in all deformities and a fusion rate of 81.5% in mild-to-moderate deformities and 40% in severe deformities.
CONCLUSION
Selective pedicle screw fixation with a long fusion for spinal stenosis with degenerative scoliosis is a treatment option for mild to moderate deformities.

Keyword

Degenerative scoliosis; Decompression; Selective pedicle screw fixation

MeSH Terms

Congenital Abnormalities
Decompression
Osteophyte
Surveys and Questionnaires
Retrospective Studies
Scoliosis*
Spinal Stenosis*

Figure

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  Fig. 1. A 52-year-old female with degenerative scoliosis with mild spinal deformity. (A) Preoperative anteroposterior radiograph shows 11 degrees of scoliotic angle, grade 1 pedicular rotation and 2mm lateral transition. (B) Preoperative lateral radiograph. (C) Postoperative anteroposterior radiograph shows 2 degrees of scoliotic angle, grade 0 pedicular rotation and 1mm lateral transition. (D) Postoperative lateral radiograph.

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  Fig. 2. A 62-year-old female with degenerative scoliosis with severe spinal deformity. (A) Preoperative anteroposterior radiograph shows 26 degrees of scoliotic angle, grade 2 pedicular rotation and 5mm lateral transition. (B) Preoperative lateral radiograph. (C) Postoperative anteroposterior radiograph shows 11 degrees of scoliotic angle, grade 1 pedicular rotation and 2mm lateral transition. (D) Postoperative lateral radiograph.

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