Abstract:Objective To explore the research progress on surgical treatment for degenerative lumbar scoliosis. Methods A computer-based online search of PubMed and CNKI databases was undertaken to identify articles about "surgical treatment for degenerative lumbar scoliosis" published in Chinese or English from January 1970 to July 2021. Forty-five articles were finally included (six articles in Chinese and 39 articles in English) from the 1 638 articles identified after considering the inclusion and exclusion criteria. We summarized the points in four aspects: the range of surgical fusion, the choice of long-segment fusion, minimally invasive techniques, and perioperative complications. Results Limited decompression and fixation are suggested for patients with acceptable sagittal balance, young patients, patients with functional requirements, patients with poor physical conditions who cannot undergo general anesthesia, and patients with a width/length index less than 0.36. Open surgery with long-segment fixation and fusion is necessary for patients with severe or rapidly progressing sagittal and/or coronal imbalance, rotational deformity, lumbar spondylolisthesis, or instability with rigid degenerative scoliosis. For patients with degenerative scoliosis undergoing long-segment fixation and fusion surgery, the choice of upper and lower vertebrae should follow the principle of individualization. At present, most of the minimally invasive treatments for degenerative scoliosis are reported by single centers. Although the curative effect is satisfactory, minimally invasive technique is not suitable for all patients with degenerative scoliosis. The long-term curative effect of revision surgery needs to be observed in the future. Conclusion Although the treatment methods for degenerative lumbar scoliosis are diversified, the main principle is individualization. Surgical plan should consider patient's general condition, imaging characteristics, clinical symptoms, and habits of the surgeon. The primary principle is relief of the clinical symptoms at the low cost of surgical trauma. The rapid development of minimally invasive technology has added new options for the surgical treatment of degenerative scoliosis. However, long-term follow-up observation is needed to evaluate their therapeutic effects.
王辉, 丁文元. 退变性腰椎侧凸的手术治疗进展[J]. 中华解剖与临床杂志, 2022, 27(7): 527-532.
Wang Hui, Ding Wenyuan. Research progress on surgical treatment for degenerative lumbar scoliosis. Chinese Journal of Anatomy and Clinics, 2022, 27(7): 527-532.
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