Clinical evaluation of indirect decompression treatments for degenerative adult idiopathic scoliosis

Abstract

Study design: Prospective case series.

Objective: Degenerative idiopathic scoliosis can be a cause of back pain. We sought to explore the feasibility and effectiveness of indirect decompression treatment in posterior correction and fusion for adult idiopathic scoliosis patients with radiculopathy and combined lateral olisthesis and/or foraminal stenosis.

Methods: Thirty seven degenerative adult idiopathic scoliosis patients with radiculopathy were recruited. Prostration or body traction alleviated the neurological deficit in these patients. Their symptoms were aggravated, when patients stood up. Imaging was used to assess lateral olisthesis and/or foraminal stenosis. All patients underwent posterior pedicle screw fixation, deformity correction, dorsal lamina and posterolateral bone grafting with the indirect decompression treatment. Clinical examinations including visual analog scale (VAS), oswestry disability index (ODI) scores, and images were performed pre- and post-operation and during follow-up visits.

Results: Twenty seven patients were followed for the average of 30.8 months. No serious complication was observed. The cobb's angle, lateral olisthesis, thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis, VAS and ODI scores, coronal and sagittal balance were significantly improved among the patients who underwent the indirect decompression treatment. All patients had eliminated neurological deficit at their final follow-ups.

Conclusions: The indirect decompression treatment in the posterior correction and fusion can be effective for adult idiopathic scoliosis patients with radiculopathy and combined lateral olisthesis and/or foraminal stenosis. This indicates the premise of strict operation indication.