OBJECTIVE: A systematic review to evaluate the role of surgery for treating degenerative scoliosis (DS) in terms of improved function (Oswestry Disability Index [ODI]) and correction of deformity (Cobb angle); safety outcomes included complication and repeat surgery rates. METHODS: A search of the MEDLINE, ISI Web of Knowledge and Cochrane Library databases was performed. The methodological quality of each study was assessed according to standardized criteria and data were extracted. RESULTS: A total of 16 studies including 553 patients with DS met the eligibility criteria for inclusion. The mean ODI score at final follow-up was 36.0 ± 7.8 (304 patients) and the mean decrease in ODI was 23.3 ± 11.3 (302 patients). Mean reduction in curve angle (as a percentage of the original curve) was 48.5 ± 21.0% (527 patients). The overall incidence of complications was 49.0% (171 in 349 patients) and the rate of repeat surgery was 15.3% (61 in 398 patients). CONCLUSIONS: Despite a high incidence of complications and reoperations, surgery was an effective and reasonable treatment for DS, providing significant functional improvement and deformity correction.
OskouianRJJrShaffreyCI: Degenerative lumbar scoliosis. Neurosurg Clin N Am2006; 17: 299–315.
9.
BradfordDSTayBKHuSS: Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine (Phila Pa 1976)1999; 24: 2617–2629.
10.
PrommahachaiAWittayapirotKJirarattanaphochaiK: Correction with instrumented fusion versus non-corrective surgery for degenerative lumbar scoliosis: A systematic review. J Med Assoc Thai2010; 93: 920–929.
11.
YadlaSMaltenfortMGRatliffJK: Adult scoliosis surgery outcomes: A systematic review. Neurosurg Focus2010; 28: E3.
12.
FairbankJCPynsentPB: The Oswestry Disability Index. Spine (Phila Pa 1976)2000; 25: 2940–2952.
13.
WrightJGSwiontkowskiMFHeckmanJD: Introducing levels of evidence to the journal. J Bone Joint Surg Am2003; 85-A: 1–3.
14.
OremusMWolfsonCPerraultA: Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer's disease drug trials. Dement Geriatr Cogn Disord2001; 12: 232–236.
15.
SlimKNiniEForestierD: Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg2003; 73: 712–716.
16.
MarchesiDGThalgottJSAebiM: Application and results of the AO internal fixation system in nontraumatic indications. Spine (Phila Pa 1976)1991; 16 (3 suppl): S162–S169.
17.
GrubbSALipscombHJSuhPB: Results of surgical treatment of painful adult scoliosis. Spine (Phila Pa 1976)1994; 19: 1619–1627.
PatederDBKebaishKMCascioBM: Posterior only versus combined anterior and posterior approaches to lumbar scoliosis in adults: A radiographic analysis. Spine (Phila Pa 1976)2007; 32: 1551–1554.
20.
BervenSHDevirenVMitchellB: Operative management of degenerative scoliosis: an evidence-based approach to surgical strategies based on clinical and radiographic outcomes. Neurosurg Clin N Am2007; 18: 261–272.
21.
WuCHWongCBChenLH: Instrumented posterior lumbar interbody fusion for patients with degenerative lumbar scoliosis. J Spinal Disord Tech2008; 21: 310–315.
22.
GlassmanSDCarreonLYDjurasovicM: Lumbar fusion outcomes stratified by specific diagnostic indication. Spine J2009; 9: 13–21.
23.
KlubaTDikmenliGDietzK: Comparison of surgical and conservative treatment for degenerative lumbar scoliosis. Arch Orthop Trauma Surg2009; 129: 1–5.
24.
CrandallDGRevellaJ: Transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion as an adjunct to posterior instrumented correction of degenerative lumbar scoliosis: three year clinical and radiographic outcomes. Spine (Phila Pa 1976)2009; 34: 2126–2133.
25.
KhanSNHoferMAGuptaMC: Lumbar degenerative scoliosis: outcomes of combined anterior and posterior pelvis surgery with minimum 2-year follow-up. Orthopedics2009; 32: 258.
26.
Di SilvestreMLolliFBakaloudisG: Dynamic stabilization for degenerative lumbar scoliosis in elderly patients. Spine (Phila Pa 1976)2010; 35: 227–234.
27.
TransfeldtEEToppRMehbodAA: Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy. Spine (Phila Pa 1976)2010; 35: 1872–1875.
28.
LiFChenQChenW: Posterior-only approach with selective segmental TLIF for degenerative lumbar scoliosis. J Spinal Disord Tech2011; 24: 308–312.
29.
PloumisAAlbertTJBrownZ: Healos graft carrier with bone marrow aspirate instead of allograft as adjunct to local autograft for posterolateral fusion in degenerative lumbar scoliosis: A minimum 2-year follow-up study. J Neurosurg Spine2010; 13: 211–215.
30.
KeorochanaGTawonsawatrukTLaohachareonsombatW: The results of decompression and instrumented fusion with pedicular screw plate system in degenerative lumbar scoliosis patients with spinal stenosis: A prospective observational study. J Med Assoc Thai2010; 93: 457–461.
31.
SansurCASmithJSCoeJD: Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976)2011; 36: E593–E597.
32.
ChoKJSukSIParkSR: Short fusion versus long fusion for degenerative lumbar scoliosis. Eur Spine J2008; 17: 650–656.
33.
McDonnellMFGlassmanSDDimarJR2nd: Perioperative complications of anterior procedures on the spine. J Bone Joint Surg Am1996; 78: 839–847.
34.
MokJMCloydJMBradfordDS: Reoperation after primary fusion for adult spinal deformity: rate, reason, and timing. Spine (Phila Pa 1976)2009; 34: 832–839.
35.
PichelmannMALenkeLGBridwellKH: Revision rates following primary adult spinal deformity surgery: six hundred forty-three consecutive patients followed-up to twenty-two years postoperative. Spine (Phila Pa 1976)2010; 35: 219–226.
36.
PloumisATransfeldtEEGilbertTJ: Radiculopathy in degenerative lumbar scoliosis: correlation of stenosis with relief from selective nerve root steroid injections. Pain Med2011; 12: 45–50.
