Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?

Study Design. A retrospective study. Purpose. Posterolateral fusion with pedicle screw instrumentation used for degenerative lumbar scoliosis can lead to several complications. In elderly patients without sagittal imbalance, dynamic stabilization could represent an option to avoid these adverse eve...

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Main Authors: Mario Di Silvestre, Francesco Lolli, Tiziana Greggi, Francesco Vommaro, Andrea Baioni
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2013/365059
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author Mario Di Silvestre
Francesco Lolli
Tiziana Greggi
Francesco Vommaro
Andrea Baioni
author_facet Mario Di Silvestre
Francesco Lolli
Tiziana Greggi
Francesco Vommaro
Andrea Baioni
author_sort Mario Di Silvestre
collection DOAJ
description Study Design. A retrospective study. Purpose. Posterolateral fusion with pedicle screw instrumentation used for degenerative lumbar scoliosis can lead to several complications. In elderly patients without sagittal imbalance, dynamic stabilization could represent an option to avoid these adverse events. Methods. 57 patients treated by dynamic stabilization without fusion were included. All patients had degenerative lumbar de novo scoliosis (average Cobb angle 17.2°), without sagittal imbalance, associated in 52 cases (91%) with vertebral canal stenosis and in 24 (42%) with degenerative spondylolisthesis. Nineteen patients (33%) had previously undergone lumbar spinal surgery. Results. At an average followup of 77 months, clinical results improved with statistical significance. Scoliosis Cobb angle was 17.2° (range, 12° to 38°) before surgery and 11.3° (range, 4° to 26°) at last follow-up. In the patients with associated spondylolisthesis, anterior vertebral translation was 19.5% (range, 12% to 27%) before surgery, 16.7% (range, 0% to 25%) after surgery, and 17.5% (range, 0% to 27%) at followup. Complications incidence was low (14%), and few patients required revision surgery (4%). Conclusions. In elderly patients with mild degenerative lumbar scoliosis without sagittal imbalance, pedicle screw-based dynamic stabilization is an effective option, with low complications incidence, granting curve stabilization during time and satisfying clinical results.
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spelling doaj-art-de252ff3b42246c28ccb3141a566844e2025-08-20T03:26:21ZengWileyAdvances in Orthopedics2090-34642090-34722013-01-01201310.1155/2013/365059365059Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?Mario Di Silvestre0Francesco Lolli1Tiziana Greggi2Francesco Vommaro3Andrea Baioni4Spine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136 Bologna, ItalySpine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136 Bologna, ItalySpine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136 Bologna, ItalySpine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136 Bologna, ItalySpine Surgery Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, 40136 Bologna, ItalyStudy Design. A retrospective study. Purpose. Posterolateral fusion with pedicle screw instrumentation used for degenerative lumbar scoliosis can lead to several complications. In elderly patients without sagittal imbalance, dynamic stabilization could represent an option to avoid these adverse events. Methods. 57 patients treated by dynamic stabilization without fusion were included. All patients had degenerative lumbar de novo scoliosis (average Cobb angle 17.2°), without sagittal imbalance, associated in 52 cases (91%) with vertebral canal stenosis and in 24 (42%) with degenerative spondylolisthesis. Nineteen patients (33%) had previously undergone lumbar spinal surgery. Results. At an average followup of 77 months, clinical results improved with statistical significance. Scoliosis Cobb angle was 17.2° (range, 12° to 38°) before surgery and 11.3° (range, 4° to 26°) at last follow-up. In the patients with associated spondylolisthesis, anterior vertebral translation was 19.5% (range, 12% to 27%) before surgery, 16.7% (range, 0% to 25%) after surgery, and 17.5% (range, 0% to 27%) at followup. Complications incidence was low (14%), and few patients required revision surgery (4%). Conclusions. In elderly patients with mild degenerative lumbar scoliosis without sagittal imbalance, pedicle screw-based dynamic stabilization is an effective option, with low complications incidence, granting curve stabilization during time and satisfying clinical results.http://dx.doi.org/10.1155/2013/365059
spellingShingle Mario Di Silvestre
Francesco Lolli
Tiziana Greggi
Francesco Vommaro
Andrea Baioni
Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?
Advances in Orthopedics
title Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?
title_full Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?
title_fullStr Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?
title_full_unstemmed Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?
title_short Adult's Degenerative Scoliosis: Midterm Results of Dynamic Stabilization without Fusion in Elderly Patients—Is It Effective?
title_sort adult s degenerative scoliosis midterm results of dynamic stabilization without fusion in elderly patients is it effective
url http://dx.doi.org/10.1155/2013/365059
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