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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

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Less-invasive surgical correction of adult degenerative scoliosis – complications and clinical outcome

Meeting Abstract

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  • Kai-Michael Scheufler - Abteilung Neurochirurgie, NeuroZentrum Zürich, Klinik Hirslanden Zürich, Schweiz; Orthopädie & Wirbelsäulenchirurgie, Birshof-Klinik Münchenstein, Basel, Schweiz
  • Donatus Cyron - Abteilung Neurochirurgie, NeuroZentrum Zürich, Klinik Hirslanden Zürich, Schweiz
  • Hildegard Dohmen - Abteilung Neurochirurgie, NeuroZentrum Zürich, Klinik Hirslanden Zürich, Schweiz
  • Anke Eckardt - Orthopädie & Wirbelsäulenchirurgie, Birshof-Klinik Münchenstein, Basel, Schweiz

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1789

doi: 10.3205/10dgnc260, urn:nbn:de:0183-10dgnc2607

Published: September 16, 2010

© 2010 Scheufler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Surgical correction of adult degenerative scoliosis is a technically demanding procedure with a considerable complication rate. Extensive blood loss has been identified as significant factor linked to unfavorable outcome. Less-invasive surgical technique may be useful to reduce perioperative morbidiy and improve short-term outcome.

Methods: 30 patients (age: 64–88 y) with progressive postural impairment, back pain, radiculopathy and neurogenic claudication due to degenerative scoliosis were treated by less-invasive image-guided correction (3 to 8 segments) by multisegmental TLIF and facet fusions. With a mean follow-up of 19.6 months, intraoperative blood loss, curve correction, fusion and complication rates, duration of hospitalization, incidence of hardware related problems and clinical outcome parameters were assessed using multivariate analysis.

Results: Satisfactory multiplanar correction was obtained in all patients. Mean intraoperative blood loss was 771.7±231.9ml, time to full ambulation 0.8±0.6days, and length of stay 8.2±2.9days. After 12 months, preoperative SF12v2 physical component summary scores (20.2±2.6), VAS scores (7.5±0.8) and ODI (57.2±6.9) improved to 34.6±3.9, 2.63±0.6 and 24.8±7.1, respectively. The rate of major and minor complications was 23.4% and 59.9%, respectively. 90% of patients rated treatment success as excellent, good or fair. No evidence of fusion was found in 11% of treated segments at 12 monhts.

Conclusions: Less-invasive image-guided correction of degenerative scoliosis in elderly patients with significant comorbidity yields a favorable complication profile. Significant improvements in spinal balance, pain, and functional scores mirrored expedited ambulation and early resumption of daily activities. Less-invasive techniques appear suitable to reduce periprocedural morbidity, especially in elderly patients and individuals with significant medical risk factors.