【摘 要】
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BACKGROUND:Adult degenerative scoliosis is a condition with increasing prevalence and medical and socioeconomic importance.Surgery is fraught with a significant complication rate in an elderly multimo
【机 构】
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Department of Orthopaedics,301 hospital,Beijing
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BACKGROUND:Adult degenerative scoliosis is a condition with increasing prevalence and medical and socioeconomic importance.Surgery is fraught with a significant complication rate in an elderly multimorbid patient population.OBJECTIVE:To assess technical feasibility and radiographic results of image-guided less invasive correction of adult degenerative scoliosis.METHODS:16 individuals(age,64-78 years)with progressive deformity(coronal Cobb angles>25°and<85°),intractable back pain,radiculopathy,or neurogenic claudication were treated by less invasive surgery(mini-ALIF(L2/3-L4/5),unilateral transforaminal interbodycage insmunentation(L5/S1)and selective MIS nerer root decompression+percutanerious pedicle screws fixation)spanning 4 to 9 segments (average,6 segments),using biplanar fluoroscopy or intraoperative computed tomography(iCT)-based navigation.Accuracy of screw placement,curve correction,and fusion rate were evaluated during a mean followup of 24.5 months.RESULTS:With 232 screws implanted,misplacement(grade Ⅱ or greater)was not observed,and no implants required revision.Mean sagittal(coronal)Cobb angle correction was 24.2±8.2°(34.1±15.1).Mean lumbar lordosis increased from.and sagittal balance was reduced from 30.8±9.2 to 10.3±6.4 inrn.Solid fusion was confirmed in 90.3％of instrumented segments at 16 months.CONCLUSION:MIS less invasive surgical technique combined mini-ALIF technique in correction of adult degenerative scoliosis can achieve good deformity correction and better clinical outcome.
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