SURGICAL TREATMENT OF THORACOLUMBAR AND LUMBAR SCOLIOSIS

Abstract

Study Design. A clinical retrospective study was conducted.

Objective. To evaluate the clinical and radiographic outcome of anterior and posterior instrumental correction for lumbar and thoracolumbar scoliosis.

Methods. Thirty-three patients who underwent anterior and/or posterior surgical reconstruction for thoracolumbar and lumbar scoliosis were included in this study. Out of them there were 14 adolescents (range, 14-16 years) and 19 - adults (range, 32-62 years). In 7 adolescents correction was performed with CDI, and in 7 - with anterior Hopf instrumentation. In adult patients only posterior instrumentation (CDI) was used. Seven patients underwent only correction and posterior spinal fusion. In 10 cases with clinical and radiological signs of spinal stenosis multilevel decompression and posterior instrumentation were performed and out of them 5 cases were followed by additional interbody fusion with Interfix cages.

Results. The correction of deformity in adolescents treated with anterior or posterior instrumentation ranged from 40 % to 90 %. In patients with anterior instrumentation correction of the total curve and central angles was insignificantly higher. In adult patients clinical improvement with pain relief was achieved in all cases. Radiographic investigations demonstrated improvement with partial correction of deformity and fusion.

Conclusions. Both anterior and posterior instrumentations are effective techniques for the management of lumbar and thoracolumbar scoliosis in adolescents. In adult patients with lumbar and thoracolumbar scoliosis the goal of surgical treatment is first of all clinical and neurological improvement, which can be achieved by spinal decompression followed by posterior instrumentation.