The clinical effectiveness and complications of lumbar selective fenestration and concave-side fusion (LSFCF) in degenerative lumbar scoliosis (DLS) combined with lumbar spinal stenosis (LSS)

Abstract

Purpose: This retrospective study was performed to analyze the clinical effects and complications of LSFCF in the surgical treatment of DLS combined with lumbar spinal stenosis (LSS).

Methods: A total of 26 eligible patients (mean age, 64.73 y; 17 men, 9 women) with DLS combined with LSS were included and LSFCF surgery was performed. An independent spine surgeon retrospectively reviewed the medical records and radiographs of all patients to evaluate surgical data and surgery-related complications. Preoperative, postoperative, and follow-up questionnaires were obtained to assess clinical outcomes.

Results: The average follow-up period of this study was 20.14 ± 5.21 months. The operation time and blood loss of patients underwent LSFCF were 129.33 ± 15.74 min and 356.13 ± 21.28 ml. The clinical effects of all patients in terms of visual analogue scale (VAS) and Oswestry disability index (ODI) have been significantly improved at the final follow-up postoperatively (P < 0.05). Complications such as infection, cerebrospinal fluid leakage, nerve injury, and internal fixation failure, etc. were not observed during the follow-up period.

Conclusion: The LSFCF surgery is a safe and effective treatment for DLS patients combined with LSS.

Keywords: DLS; LSFCF; LSS; ODI; VAS.

Fig. 1

Preoperative lateral radiographic and MRI view (A–E) of a 72-year-old female with low back pain and numbness of the right lower limb for more than 3 years. Standing long cassette coronal and sagittal radiographs before surgery (A, B). The Cobb angle and lumbar lordosis were 26° and 42°, respectively. Standing long cassette coronal and sagittal radiographs at final follow-up after LSFCF surgery (D, E). The Cobb angle improved from 26° to 4°, and lumbar lordosis changed from 42° to 45°, respectively

Fig. 2

Preoperative lateral radiographic and MRI view (A–E) of a 75-year-old female with low back pain and intermittent claudication of both lower limbs for more than half a year. According to the preoperative standing long cassette coronal and sagittal radiographs, the Cobb angles and lumbar lordosis were 15° and 51°, respectively (A, B). The postoperative standing long cassette coronal and sagittal radiographs at final follow-up showed that the Cobb angle and lumbar lordosis improved from 15° to 6° and from 51° to 54°, respectively (D, E)