Abstract：Objective To evaluate the mid-term outcome of the long and short segment fusion and internal fixation for adult degenerative scoliosis(DS).Methods Clinical data of 46 consecutive patients with degenerative scoliosis who were treated by posterior decompression and long segment or short segment instrumented fusion operation in People's Hospital of Huangshan City from January 2012 to december 2016 were collected and retrospectively analyzed. The patients were divided into long and short segment fusion fixation group. There were 17 women and 9 men with a mean age of 55 years old(range 45 to 78 years) in long segment fixation group and 13 women and 7 men with a mean age of 60.7 years old(range 45 to 82 years old) in short segment fixation group. Gender, age, fusion segments,operation time,segments of decompression, blood loss and the time of hospitalization were collected and compared. Radiologic parameters including the coronal Cobb's angle,coronal and sagittal balance of spine were recorded for the assessment of correction.The visual analogue scales(VAS) scoring for low back pain and sciatica, Japanese Orthopaedic Association(JOA) score, together with Oswestry disability index(ODI), were applied to evaluate the preoperative and postoperative quality of life.Results All the patients were followed up for average 2.2 years ( 1.5 to 3.3 years old). There were no significant differences between the age, sex, decompression segment(all P values＞0.05). However there were significant differences between the fusion segments, blood loss, operation time and time of hospitalization(all P values＜0.05). There was no significant difference between the two groups in the preoperative and postoperative follow-up of Cobb's angle and lumbar lordosis (all P values＞0.05), and the coronal sagittal balance of Cobb's angle and lumbar lordosis were significantly improved in the final follow-up of 1 year after surgery (all P values <0.05). There were significant differences between the long and the short segment fixation group pre-operation in coronal balance and sagittal balance(all P values＜0.05) , and there was no statistical difference between the two groups 1 year after surgery and at the last follow-up (all P values＞0.05). There were significant differences between the pre-operation and post-operation in radiological parameters, VAS, JOA score, and ODI (all P values＜0.05) . There were significant differences between the long and short segment fixation group in VAS score, JOA and ODI in 1year after operation and the last follow-up (all P values＜0.05).Conclusions Compared with shorter-segment fusion, long-segment fusion and internal fixation can achieve better mid-term clinical outcomes.
汪颖峰, 俞胜宝, 周建, 黄定安. 成人退变性脊柱侧凸长、短节段融合内固定术后中期疗效的分析[J]. 中华解剖与临床杂志, 2019, 24(6): 583-587.
Wang Yingfeng, Yu Shengbao, Zhou Jian, Huang Ding'an. Mid-term outcome of the long and short segment fusion and internal fixation for adult degenerative scoliosis. Chinese Journal of Anatomy and Clinics, 2019, 24(6): 583-587.
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2019, Vol. 24 
