Outcomes after surgery for cervical spine deformity: review of the literature.
ABSTRACT Symptomatic cervical kyphosis can result from a variety of causes. Symptoms can include pain, neurological deficits, and functional limitation due to loss of horizontal gaze.
The authors review the long-term functional and radiographic outcomes following surgery for symptomatic cervical kyphosis by performing a PubMed database literature search.
Fourteen retrospective studies involving a total of 399 patients were identified. Surgical intervention included ventral, dorsal, or circumferential approaches. Analysis of the degree of deformity correction and functional parameters demonstrated significant postsurgical improvement. Overall, patient satisfaction appeared high. Five studies reported mortality with rates ranging from 3.1 to 6.7%. Major medical complications after surgery were reported in 5 studies with rates ranging from 3.1 to 44.4%. The overall neurological complication rate was 13.5%.
Although complications are not insignificant, surgery appears to be an effective option when conservative measures fail to provide relief.
Article: Scoliosis in the elderly.The Journal of Bone and Joint Surgery 05/1969; 51(3):446-55. · 3.23 Impact Factor
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ABSTRACT: The frequency and characteristics of definite lumbar scoliosis in an adult common low-back pain population (n = 671) were assessed by a clinical and radiologic prospective study. The prevalence was 7.5% (N = 50), increasing with age: 2% before 45 years; 15% after 60 years. Scoliosis was revealed by low-back pain in adulthood in 86% of the cases. The mean Cobb angle was 21 +/- 11.4 degrees. A Cobb angle of more than 30 degrees was noted in 16% of the scoliotics, thus 1% of the entire population. The proportion of women increased with the severity of the scoliosis. Right and left side scolioses were equally noted. A correlation between the Cobb angle and age was found (0.3 degrees/yr; P < 0.05). Rotatory olisthesis was noted in 34% of the cases, more often in right side curves (P < 0.01). The lumbar scoliotic patients were distinguished by a more advanced age (62 +/- 12.4 yr vs. 49.6 +/- 15.5 yr; P < 0.001), a greater proportion of women (72% vs. 48%; P < 0.01), and a more likely involvement of L3 and L4 radicular pain (P < 0.05). Radicular thigh pain was related to unstable curves (P < 0.01). The lumbar scoliotic patients thus constitute a subgroup within the low-back pain population.Spine 01/1994; 19(2):123-8. · 2.16 Impact Factor
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ABSTRACT: The authors report a homogeneously investigated and surgically treated series of 40 patients with degenerative scoliosis of the lumbar spine. The series included 22 females and 18 males with a mean age of 62.8 years. The clinical presentation, the diagnostic work-up, the indication for surgery, the surgical techniques and results are reported. Final evaluation was possible in 30 patients at a mean period of observation of 59.5 months. Following a very precise diagnostic and therapeutic protocol excellent, good and satisfactory surgical results were obtained in 13 (43.3%), 16 (53.3%) and 1 (3.3%) patients, respectively. While scoliosis was converted from a mean preoperative Cobb angle of 18.7 degrees to 7.6 degrees mean pre-operative lumbar lordosis was slightly augmented from 37 degrees to 41.5 degrees. The results suggest that maintainance or correction of lumbar lordosis is more important than the conversion of the scoliotic deformity which is probably treated sufficiently by partial correction and stabilization. Observation over time indicates that the degenerative cascade evolves despite internal fixation and fusion in the majority of the patients until a stable state is reached. This stable state is probably rather the result of ankylosis of the facet joints than the effect of posterolateral fusion.Acta Neurochirurgica 02/1999; 141(1):21-6. · 1.55 Impact Factor