Curve progression after decompression surgery in patients with mild degenerative scoliosis: Clinical article

Naobumi Hosogane, Koota Watanabe, Hitoshi Kono, Masashi Saito, Yoshiaki Toyama, Morio Matsumoto

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Object. The authors undertook this study to evaluate curve progression, risk factors for curve progression, and outcomes after decompression surgery in patients with degenerative lumbar scoliosis with minimal to moderate curvature. Methods. Of 852 patients with lumbar canal stenosis treated by posterior decompression surgery, 50 patients had a lumbar curve greater than 10° at final follow-up. These patients were divided into 2 groups according to curve progression during the follow-up period: the P group (11 patients), with a curve progression of more than 5°, and the NP group (39 patients), with a curve progression of 5° or less. The authors compared preoperative parameters in these 2 groups to elucidate risk factors associated with curve progression and other surgical outcomes. Results. The average lumbar curve progression in the total group of 50 patients was 3.4° ± 3.9° (range -2.0° to 22.0°). In the P group the average curve progression was 8.5°, and in the NP group it was 2.0°. Multivariate logistic regression analysis showed no significant association between curve progression and any of the potential risk factors evaluated (including curve magnitude, decompression method, and degenerative intervertebral disc changes). Spur formation, evaluated with the Nathan classification at the concave side of the curve, tended to be greater in the P group, although the difference was not statistically significant. There was no significant difference in revision surgery rate, and none of the patients required arthrodesis due to curve progression. Clinical outcomes, evaluated with the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and the Scoliosis Research Society 22-question questionnaire, were also similar in the 2 groups. Conclusions. Surgical outcomes did not deteriorate in the P group. While curve progression after decompression surgery could not be predicted from the preoperative factors considered, spur formation at the concave side of the curve may be a candidate factor. The results of this study indicate that spinal fixation to halt deformity progression is not always necessary if the patient's pathological condition derives mainly from canal stenosis.

Original languageEnglish
Pages (from-to)321-326
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume18
Issue number4
DOIs
Publication statusPublished - 2013 Apr

Fingerprint

Scoliosis
Decompression
Pathologic Constriction
Intervertebral Disc Degeneration
Arthrodesis
Back Pain
Reoperation
Logistic Models
Regression Analysis
Research

Keywords

  • Curve progression
  • Decompression
  • Degenerative lumbar scoliosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Curve progression after decompression surgery in patients with mild degenerative scoliosis : Clinical article. / Hosogane, Naobumi; Watanabe, Koota; Kono, Hitoshi; Saito, Masashi; Toyama, Yoshiaki; Matsumoto, Morio.

In: Journal of Neurosurgery: Spine, Vol. 18, No. 4, 04.2013, p. 321-326.

Research output: Contribution to journalArticle

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