The Comparative Study Of Selective Different Surgical Treatment Of Adult Degenerative Scoliosis

Objective:Discussion on the selection of treatment of adult degenerative scolio sis, to evaluate the effectiveness and safety of different treatment methods. Method s:76patients were treated with operation, group A (non fixed non fusion group) a nd25cases only decompression, group B (fusion group)51cases underwent poste rior decompression and fusion of different segmental fixation and/or osteotomy, app lication of ODI score in the evaluation of pain and function, measuring Cobb angl e and lumbar physiology curve lordosis angle, and record the two groups of patie nts with age, operation time, intraoperative bleeding volume, operation complication s were analyzed retrospectively. Results:Group A (non fixed non fusion group) av erage operation segment in1.67±0.77segments (0.5～3), group B (fusion grou p) average fixed fusion4.2±2.45segment (2-10), a significant difference betwee n two groups (P<0.01);Two groups of operation time was-(51±18.92) min and (150±35) min, a significant difference between two groups (P<0.01);The amo unt of bleeding were (106.67±39.76) ml and (374.63±253.69) ml, a significant di fference between two groups (P<0.01);The mean duration of follow-up was28.6months (6-72months), at last follow-up, two patients clinical symptoms were si gnificantly improved compared with preoperative, ODI score was significantly better than preoperative, but there was no significant difference between two groups (P=°±.19);Group A (non fixed non fusion group) preopration Cobb’s angle was17.2°±5.45°, at last follow-up for an average of18.21°±5.08, A group of coro nal side Cobb’s angle not change significantly before operation, group B (fusion group) preoperative average of26.72°±10.7°, at last follow-up an average of10.27°±4.53°, coronal side Cobb’s corrected significantly, improve the rate of t wo groups were statistically significant difference (P<0.01); Group A (non fixed non fusion group) spinal lumbar lordosis angle before operation and at last follow-up were an average of39.74°±11.09°and38.77°±11.30°,group B (fusion group) spinal lumbar lordosis angle before operation and at last follow-up were an average of20.19°±9.87°and33.91°±7.96°, B group (fixed fusion group) than A group (non fixed non fusion group) recovery, a significant difference between two groups (P<0.01); Conclusion:Limited posterior decompre ssion and fusion of different segmental fixation and/or osteotomy in the recovery o f the patients with coronal and sagittal balance than limited posterior decompressio n, limited posterior decompression and fusion of different segmental fixation and/or osteotomy can significantly prolong the operation time, bleeding volume and incre asing operation complication. Diagnosis and treatment of adult degenerative scoliosi s is controversial, key operation selection in clinical symptoms, combined with the relevant inspection, minimize the operation trauma, shorten operation time. The deg enerative scoliosis treatment decisions for individual is the best choice.