INFLUENCE OF POSTERIOR INSTRUMENTATION AND FUSION IN DIFFERENT SEGMENTS ON THE SURGICAL PARAMETERS AND SPINAL-PELVIC PARAMETERS OF PATIENTS WITH DEGENERATIVE SCOLIOSIS

Yanzhong Luo, Chuiguo Sun, Yan Zeng, Zhaoqing Guo, Weishi Li^*

Department of Orthopaedic, Peking University Third Hospital, Beijing, 100089, PR. China

Objective: To investigate the influence of posterior instrumentation and fusion in ≤3 and ≥4 segments on the surgical parameters and spinal-pelvic parameters of patients with degenerative scoliosis. 

Methods: The clinical data of 150 patients with degenerative scoliosis admitted to our hospital from January 2012 to December 2015 were analyzed retrospectively. Among them, 108 patients un-dergoing posterior instrumentation and fusion in ≤3 segments were defined as Group A, and 42 patients undergoing posterior instrumentation and fusion in ≥4 segments were defined as Group B. 2 groups were compared in terms of surgical parameters, incidence of postoperative complications, VAS pain score, ODI score and imaging indicators before and after surgery. 

Results: The number of fused segments, intraoperative hemorrhage, operation time and length of postoperative hospital stay of Group B were significantly higher than those of Group A (P<0.05). The incidences of intraoperative and postoperative complications of Group B were significantly higher than those of Group A (P<0.05). The VAS score of low back pain, VAS score of leg pain and ODI score of both groups at the last follow-up were significantly better than those before surgery (P<0.05). There was no significant difference between two groups in terms of the above scores at the last follow-up (P>0.05). The preoperative imaging indicators of Group A were significantly better than those of Group B (P<0.05). The postoperative imaging indicators of both groups were significantly better than pre-operative ones (P<0.05). Meanwhile, the postoperative imaging indicators of Group B at the last follow-up were significantly better than those of Group A (P<0.05). 

Conclusion: According to the severity of disease, the number of instrumented segments should be selected to obtain better clinical effects in improving the spinal-pelvic parameters in patients with degenerative scoliosis. Compared with long-segment, short-segment posterior instrumentation and fusion has such advantages as minimal invasion, shorter operation time, quicker recovery after surgery and better safety.