Minimally Invasive Surgical Treatment for Adult Degenerative Lumbar Scoliosis

Objective: to compare the results of minimally invasive and open surgery in the treatment of the patients with combined symptomatic degenerative stenosis and scoliotic deformity of the lumbar spine. Patients and methods. A retrospective comparative analysis of the long-term results of 54 patients was performed. The patients were devided in two groups: open surgery (group 1, n=39) and minimally invasive surgery (group 2, n=15). Different approaches were used based on the type of deformity (according to Berzhano and Lamartine), localization and extent of lumbar stenosis. The evaluation of volume of decompression, blood loss, time of surgery and postoperative treatment, intraoperative complications, pain and patients condition were measured using clinical scales ODI, ZCQ, SF-12 was performed. Results. No differences in the type of deformity, the severity of stenosis and clinical manifestations between groups were discovered before treatment. All characteristics of the surgery (except the intraoperative complications) - blood loss, duration of surgery, and hospital stay - were significantly less in the minimally invasive group. Postoperative assessment has shown in group 1 greater regression of axial pain syndrome (p=0.03), in group 2 greater regression of radicular syndrome (p=0.03). Assessment of quality of life based on questionnaires after 2 years has revealed no differences between groups. Conclusion. Using of minimally-invasive decompression and decompression-stabilizing surgical technologies in patients with combined stenosis and deformity of the lumbar spine allow to eliminate the syndromes of neural compression, provide sufficient correction of segmental relationships and improve the quality of life.

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Compare of outcomes of minimally invasive and open surgical techniques in patients with symptomatic lumbar spine stenosis on the background of scoliotic deformity

Mlyavykh

Bokov

Aleynik

et al. 2019

N.N. Priorov Journal of Traumatology and Orthopedics

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Facet joint denervation in the treatment of patients with degenerative deformities of the lumbar spine.

Masevnin,

Ptashnikov,

Lim

et al. 2024

Traumatology and Orthopedics of Russia

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Purpose. Analysis of the results of surgical treatment of patients with degenerative deformities of the lumbar spine operated using percutaneous and endoscopic denervation techniques. Methods. Design: a retrospective monocentre cohort study. Study group - 58 patients (m/f: 16/42). Median age 64 (60-69) years, minimum follow-up period - 2 years. In 28 cases endoscopic denervation of the lumbar facet joints at the apex of the deformity on both sides was performed (group A), in 30 cases percutaneous radiofrequency denervation in the appropriate volume was performed (group В). The effectiveness of the performed treatment was evaluated on the basis of the dynamics of pain syndrome (VAS), patients' quality of life (ODI), as well as the frequency of complications and repeated surgical interventions. Results. The groups were comparable in terms of sex, age, body mass index, deformity size and pain level (p 0.05). Mean operative duration and radiation exposure were significantly higher with endoscopic intervention (p 0.001). The endoscopic denervation group showed an earlier reduction in back pain syndrome compared to the percutaneous intervention group (p 0.001). No reduction of pain syndrome was noted in 8 (26.7%) patients after percutaneous denervation. Repeated denervation was performed during the two-year follow-up period in 18 patients (60%) of the percutaneous intervention group and in 2 patients (7.1%) of the endoscopic treatment group (p 0.001). The analysis of the factors associated with the efficacy of percutaneous denervation showed the significance of the magnitude of deformation in the frontal plane. Thus, the efficiency of the performed percutaneous treatment decreased at the deformity value of 30° and more with a sensitivity of 77% and specificity of 67%. Conclusion. A more pronounced decrease in the intensity of back pain syndrome with preservation of the effect during the whole period of follow-up was noted in patients after endoscopic denervation. According to our data, the low efficacy of percutaneous denervation is due to the use of this technique in patients with severe deformity of the lumbar spine.

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Minimally Invasive Surgical Treatment for Adult Degenerative Lumbar Scoliosis

Cited by 2 publications

References 21 publications

Compare of outcomes of minimally invasive and open surgical techniques in patients with symptomatic lumbar spine stenosis on the background of scoliotic deformity

Compare of outcomes of minimally invasive and open surgical techniques in patients with symptomatic lumbar spine stenosis on the background of scoliotic deformity

Facet joint denervation in the treatment of patients with degenerative deformities of the lumbar spine.

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