title: [Influences of clinical symptoms on the selection of surgical options for adult degenerative scoliosis].
abstract: OBJECTIVE
  To retrospectively analyze the interactions between the clinical symptoms and surgical options and evaluate the surgical efficacies for adult degenerative scoliosis (DS).
  
  
  METHODS
  A total of 35 adult DS patients underwent operations at Tianjin hospital from May 1996 to December 2008. There were 23 females and 12 males with a mean age of 59.1 years (range: 45 - 74). Clinical symptoms, physical examinations and radiological findings for all patients were recorded at different stages, at 1 week, 3 months, 6 months, 1 year post-operation and per year respectively. According to different surgical options, they were classified into 3 groups: A: limited decompression; B: selective decompression & short-segment fusion; C: selective decompression & long-segment correction & fusion.
  
  
  RESULTS
  All patients had complete records with a mean follow-up period of 42.4 months (range: 24 - 168). Firstly, 9 patients in group A had no complaint of a low-back pain at pre-operation. The average coronal Cobb's angles were 15.6 ± 2.3° at pre-operation and 17.1 ± 3.3° at the latest follow-up. The radicular symptoms became greatly relieved at 1 year. Three cases complained of the aggravation of back pain. Secondly, 15 patients in group B mainly complained of a low-back pain at pre-operation. It was combined with lower-limb radiation pain in 6 patients and nerve claudication in 9 cases. The average coronal Cobb's angles were 14.1 ± 4.6° at pre-operation and 24.4 ± 6.7° at the latest follow-up. However, 12 patients experienced the progression of scoliosis. Thirdly, 11 patients in group C experienced a low-back pain at pre-operation while 5 cases with lower-limb radiation pain and 6 with claudication. The mean coronal Cobb's angles were 22.3 ± 9.2° at pre-operation and 12.2 ± 4.7° at the latest follow-up. Among 4 patients with residual pains, none required revision.
  
  
  CONCLUSIONS
  For the DS patients, it is quite important for the surgical options to comprehensively analyze the neurological signs, imaging data and clinical symptoms. However, the fusion end vertebrae should always avoid the vicinity or apex of curve if the short-segment fusion is selected.
authors.affiliation: Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China. doczhaodong@yahoo.com.cn
authors.forename: Dong
authors.initials: D
authors.lastname: Zhao
authors.forename: Shu-cai
authors.initials: SC
authors.lastname: Deng
authors.forename: Zhi-ming
authors.initials: ZM
authors.lastname: Sun
authors.forename: Ning
authors.initials: N
authors.lastname: Ji
authors.forename: He-yuan
authors.initials: HY
authors.lastname: Zhao
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012600:Scoliosis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome