title: [Treatment of degenerative lumbar scoliosis with selective segmental transforaminal lumbar interbody fusion].
abstract: OBJECTIVE
  To explore the treatment outcomes of degenerative lumbar scoliosis (DLS) with selective segmental transforaminal lumbar interbody fusion (TLIF).
  
  
  METHODS
  The clinical data were analyzed for a total of 42 cases with degenerative scoliosis from November 2008 to March 2011.There were 14 males and 28 females with a mean age of 62.4 years (range, 41-76).The indications for TLIF of motion segment included segmental instability and significant upper endplate obliquities of L3 or L4.Interbody spinal fusion was performed for 3 segments in 3 cases; 2 in 17; 1 in 22.All patients were followed postoperatively with a mean duration of 1.6 years (range, 0.5-3).The imaging examinations included Cobb angle of scoliosis and lumbar lordosis angle.The clinical symptoms were evaluated with Oswestry disability index (ODI) score.
  
  
  RESULTS
  The mean preoperative Cobb angle of 32.7° ± 12.4° was significantly corrected to 9.2° ± 5.5° at the final follow-up (t = 14.86, P < 0.05) with a correction rate of 71.8%. The mean preoperative lumbar lordosis angle of 25.5° ± 12.6° was also significantly corrected to 39.3° ± 8.5° (t = 12.11, P < 0.05) with a correction rate of 46.4%.There was significant difference (P < 0.05) in ODI between preoperation (43.8 ± 5.6) and postoperation (18.7 ± 1.8).But no significant difference (P > 0.05) existed in ODI between postoperation (18.7 ± 1.8) and the final follow-up (23.6 ± 2.3). And 86% of the patients showed considerable symptomatic improvement of neurogenic intermittent claudication. And clinical symptoms and functional tolerance for daily activities improved postoperatively in 92%. At the follow-up after 6 months postoperatively, all operated segments achieved fusion standard and no pseudoarthrosis formed.
  
  
  CONCLUSIONS
  Selective segmental TLIF is helpful in correcting lumbar lordosis, segmental deformity and translation. And it offers better outcomes of posterior spinal fusion for the treatment of DLS.
authors.affiliation: Department of Orthopedics, Affiliated First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China. Email: thunderwang@126.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.forename: Qing-hua
authors.initials: QH
authors.lastname: Zhao
authors.forename: Ji-wei
authors.initials: JW
authors.lastname: Tian
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D012600:Scoliosis / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome