title: [Surgical treatment of degenerative lumbar scoliosis with spinal stenosis].
abstract: OBJECTIVE
  To investigate the clinical effects of limited decomression, fixation, and fusion in treating degenerative scoliosis with spinal stennosis.
  
  
  METHODS
  From June 2002 to January 2009, 26 patients of degenerative scoliosis with spinal stenosis were treated with limited decomression, fixation, and fusion. There were 6 males and 20 females with an average age of 61.3 years (ranged, 51 to 72 years). Course of disease of spinal stenosis was from 11 months to 6 years with an average of 36 months. X-ray, CT, MRI examination were performed preoperatively for all the cases and myelography was performed for 6 cases. Preoperative Cobb's angle,focal lordosis angle,the distance between C7 plumb line (C7PL) and upper edge of S1 vertebral body (SVA), and the distance between C7PL and center sacral vertical line (CSVL) were (22.0 +/- 10.1) degrees, (21.6 +/- 10.2) degrees, (7.6 +/- 6.4) cm, (6.8 +/- 5.6) cm respectively. Measured Cobb's angle, focal lordosis angle, SVA, CSVL after operation and final follow-up were compared with preoperative data. JOA score system were used to evaluate clinical effects.
  
  
  RESULTS
  The operative time All the patients were followed up from 1.3 to 5 years with an average of 2.5 years. Postoperative and final follow-up, Cobb's angle was (10.5 +/- 8.2) degrees, (8.8 +/- 5.2) degrees, respectively; focal lordosis angle was (25.4 +/- 14.2) degrees, (31.6 +/- 13.2) degrees, respectively; SVA was (0.6 +/- 3.3) cm, (-1.2 +/- 2.5) cm,respectively; CSVL was (2.8 +/- 1.3) cm, (1.6 +/- 1.2) cm, respectively. There was significant difference in data before and after operation. Preoperative, instantly postoperative, final follow-up, JOA score was 11.0 +/- 1.7, 22.4 +/- 2.4, 24.0 +/- 2.1, respectively; 13 cases obtained excellent results, 8 good, 3 fair, 2 poor. Loss of correction occurred in one case. No collapse of intervertebral space, nerve injury, breakage of fixation system were found.
  
  
  CONCLUSIONS
  Surgical treatment with limited decompression, pedicle screw fixation and fusion is effective method for degenerative scoliosis with spinal stenosis, individualized surgery design should be made according to clinical symptoms, signs and imaging features.
authors.affiliation: Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310000, Zhejiang, China.
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Wu
authors.forename: Wei-Xing
authors.initials: WX
authors.lastname: Xu
authors.forename: Song-Jun
authors.initials: SJ
authors.lastname: Lai
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Di
authors.initials: D
authors.lastname: Lu
mesh_terms: D000368:Aged; D001863:Bone Screws; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013130:Spinal Stenosis / Q000601:surgery*