Du Jian-Wei, Zhang Lei-Ming, Yan Yu-Qiu, Zhang Ya-Ning, Rong Xue-Qin, Xiao Song-Hua, Zhang Xi-Feng
Department of Orthopedics, Affiliated Hospital of Yangzhou University, Yangzhou, China.
Department of Neurosurgery, The Sixth Medical Center of PLA General Hospital, Beijing, China.
Front Surg. 2023 Jan 6;9:730504. doi: 10.3389/fsurg.2022.730504. eCollection 2022.
Adult degenerative scoliosis (ADS) is a serious disease that often affects middle-aged and elderly people. ADS does not only cause sagittal and coronal deformity of the lumbar spine but also causes severe back and leg pain secondary to the compression of the neural structures. Open surgery remains the main method for correcting the occurring deformity and decompression of the neural structures; however, its benefit is limited in cases of large trauma. Minimally invasive spinal (MIS) surgery is an alternative method that has recently witnessed rapid development. It has the advantage of providing rapid recovery with less trauma as compared to conventional open surgery. We report two cases of ADS treated with percutaneous spinal endoscopic-assisted lumbar interbody fusion (EALIF) and percutaneous pedicle screw fixation. Both cases had moderate deformities of the lumbar spine (load-sharing classification 4-7 points) with severe back and leg pain, and they underwent successful MIS surgery. At 6 months of follow-up, the visual analog scale and Oswestry disability index scores of both patients improved and the deformity was corrected. For moderate ADS, percutaneous spinal EALIF and percutaneous pedicle screw fixation may achieve an effective correction of the deformity with direct decompression of neural structures.
成人退变性脊柱侧凸(ADS)是一种常影响中老年人的严重疾病。ADS不仅会导致腰椎矢状面和冠状面畸形,还会因神经结构受压继发严重的腰腿痛。开放手术仍然是矫正所发生畸形和解除神经结构压迫的主要方法;然而,在创伤较大的情况下,其益处有限。微创脊柱(MIS)手术是一种近年来发展迅速的替代方法。与传统开放手术相比,它具有创伤小、恢复快的优点。我们报告了两例采用经皮脊柱内镜辅助腰椎椎间融合术(EALIF)和经皮椎弓根螺钉固定治疗的ADS病例。两例患者均有中度腰椎畸形(载荷分担分类4 - 7分)并伴有严重腰腿痛,且均成功接受了MIS手术。随访6个月时,两名患者的视觉模拟评分和Oswestry功能障碍指数评分均有所改善,畸形得到矫正。对于中度ADS,经皮脊柱EALIF和经皮椎弓根螺钉固定可有效矫正畸形并直接解除神经结构压迫。