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| MA Qingwei,LI Weishi,SUN Zhuoran.The postoperative effect of lumbar lordosis correction on patients with degenerative lumbar scoliosis[J].Chinese Journal of Spine and Spinal Cord,2017,(12):1057-1062. |
| The postoperative effect of lumbar lordosis correction on patients with degenerative lumbar scoliosis |
| Received:September 22, 2017 Revised:December 11, 2017 |
| English Keywords:Degenerative lumbar scoliosis Sagittal balance Ideal lumbar lordosis Postoperative effect |
| Fund:首都临床特色应用研究专项基金（编号：z151100004015101） |
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| English Abstract: |
| 【Abstract】 Objectives: Prospective evaluation of the lumbar lordosis correction in patients with degenerative lumbar scoliosis(DLS) undergoing long-segmental operation. Methods: In our hospital, patients with DLS who underwent long-segment fixation(at least 4 vertebrae) were recruited. The ideal matched relation of the normal-elder people was LL=0.6PI+0.4TK+10°. The patients were divided into group A(matched group, postoperative LL in ideal LL±10°) and group B(mismatched group, postoperative LL out of ideal LL±10°). The pelvic and spinal parameters(Cobb angle, coronal vertical axis, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis) were measured on the anteroposterior and lateral radiographs. Pre- and post-operative symptoms were assessed by using the visual analog scale(VAS) for low back pain and leg pain. Oswestry disability index(ODI) was used to quantify disability. All patients achieved at least one-year follow-up. Parameters and clinical outcomes were compared by using independent t-test． Results: A total of 100 patients(53 in group A and 47 in group B) were included, with 43 males and 57 females, the average Cobb angle was 17.5°±7.8°. There was no significant difference between two groups in follow-up time, surgical segment, preoperative Cobb angle, preoperative CVA, preoperative LL, SS, and SVA(P>0.05). The LL, SS, PT and SVA of the two groups were significantly different after operation(P<0.01). The LL of group A significantly improved from preoperative 31.6°±15.5° to postoperative 42.2°±10.2°. The TK, SS increased and PT decreased. The postoperative SVA improved from 46±37.9mm to 17.9±28.5mm. While the sagittal parameters of group B showed no difference between pre- and post-operation. The VAS score or ODI score of the two groups significantly improved compared to the preoperative scores. After 3-6 months short-term follow-up, there was no significant difference between the two groups in VAS score and ODI score, but the VAS score of group A significantly improved after 12 months compared with group B(P＜0.05). The average ODI score of patients in group A was lower than that in group B, though there was no significant difference(P=0.08) between the two groups. Conclusions: The ideal LL(matched relation between LL and PI, TK) derived from the asymptomatic Chinese elder populations can rebalance the spine and lead to excellent clinical outcomes in DLS patients. |
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