SURGICAL MANAGEMENT OF DEGENERATIVE LUMBER SCOLIOSIS
Main Article Content
Keywords
Cobb angle, Degenerative lumber scoliosis, Management, Outcomes, RMDQ
Abstract
Background: Surgically treating degenerative lumber scoliosis (DLS) alleviates radiating pain and claudication and corrects deformity. In DLS, the key pathophysiological idea to understand is the unequal degradation of discs and facet joints, resulting in a gradual imbalance in the spine's sideways curvature under pressure. Additional complications in the pathophysiology of adult degenerative scoliosis encompass the thickening of the ligamentum flavum, loosening of the interspinous ligament, and the progression towards spinal instability. This work aimed to evaluate the surgical intervention outcomes in DLS.
Methods: A prospective cohort study was conducted on 30 individuals aged ≥ 51 years with DLS abnormalities identified using clinical examination, radiography, or magnetic resonance imaging. Patients were evaluated preoperatively and one month postoperatively using the Roland Morris Disability Questionnaire (RMDQ).
Results: The mean estimated blood loss was 475.2± 197.5 ml. Regarding complications, wound infection occurred in 1 (3.33%) patient; incidental durotomy occurred in 3 (10%) patients; postoperative hematoma occurred in 2 (6.67%) patients; and neurological deficit did not occur in any patient. The mean hospital stays were 3.9± 1.05 days. The mean estimated blood loss was 475.2± 197.5 ml. Cobb angle and RMDQ showed significant improvement after treatment.
Conclusions: Surgical management of DLS exhibited significant improvement with low complications and short hospital stays. In DLS the Cobb angle assumes a less prominent position compared to idiopathic curves, and factors such as lateral listhesis, spondylolisthesis, spinal stenosis, and sagittal imbalance carry equal, if not greater, role.
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Dr.Mahmoud kamel Elawady
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Dr. Rasha Abdelhamid Zaki
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Dr.Mohammed Melegy Rabie
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Dr. Mahmoud Faried bathalla
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Dr. Rabab Yahya AbdAl-kareem
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Dr. Mostafa Gamaleldin Zahr
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Dr. Samy Ibrahim kamel
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt