Correction with instrumented fusion versus non-corrective surgery for degenerative lumbar scoliosis: a systematic review.
OBJECTIVE
To evaluate the effect of surgical treatment between correction and non-correction surgery for degenerative lumbar scoliosis by systematic review method.


METHODS
The database inclusions were PubMed (January 1, 1960 to March 31, 2009), EMBASE (January 1, 1985 to March 31, 2009), The Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and various articles. Grey literature was searched from Scirus. The quality of the studies was graded by MINORS. Studies that were classified level I to IV were included in analysis of surgical treatment outcome in degenerative lumbar scoliosis. Patient centered outcomes, surgical outcomes, and complication were collected. Two reviewers independently assessed trial quality and extracted data.


RESULTS
Seventeen studies were included in analysis comprising 598 patients with degenerative lumbar scoliosis and treated by operative treatment. Overall, 451 patients received correction procedure. All trials were non-randomized and noncomparative studies. Almost all level evidence of the study was level III to IV Overall results were comparable between correction and non-corrective operation.


CONCLUSIONS
There were insufficient good-quality comparative studies for surgical treatment outcome comparing between corrective deformity and non-corrective procedures. The correction of deformity in degenerative lumbar scoliosis was classified Level 2C (very weak recommendations).
Prommahachai
Akom
A
Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. prommahachai@gmail.com
Wittayapirot
Krengkrai
K
Jirarattanaphochai
Kitti
K
Sae-Jung
Surachai
S
D019299:Decompression, Surgical; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion