To evaluate the clinical
outcome of precision surgical treatment of lumbar spinal stenosis
accompanied with degenerative scoliosis under the Quadrant retractor in
From July 2008 to June 2013, 26
patients with spinal stenosis accompanied with degenerative lumbar
scoliosis were surgically treated by the aforesaid technique. The
patients, including 10 males and 16 females aged from 64 to 78 years
with an average of 70.8 years, complained of low back pain accompanied
with unilateral leg pain and intermittent claudication with disease
course of 27.48 months on average ranged from 6 months to 4 years.
Preoperative X-ray, CT and MRI revealed lumbar canal stenosis
accompanied with scoliosis of Cobb angle >10° in all the 26 patients,
including L4/5 involved in 19 and L5 S1 involved in 7. The visual
analog scale (VAS) Oswestry disability index (ODI) and modified MacNab
criteria were used for evaluation of the outcomes.
the patients underwent operation successfully with operation time of
(32.69±5.59) min, blood loss of (33.84±13.61) ml and hospital stay of
(9.32±4.61) day on average. All the patients achieved primary incision
healing without complications, such as neurovascular injury and
infection. All of them were followed up for 12 to 36 months with an
average of 21.3 months. The VAS of leg pain significantly decreased from
(5.50±1.03) preoperatively to (1.31±0.79) at 6 months after operation
(P<0.05) , similarly, the ODI significantly reduced from
(52.18±6.71)% to (15.57±2.57)% (P<0.05) . According to modified
MacNab criteria, 10 patients got excellent result and 16 patients had
good result at the latest follow up.
In case of strict selection of the patients who has proper indications, the surgical procedure under the Quadrant retractor is a safe, effective and minimally invasive technique for treatment of spinal stenosis accompanied with degenerative lumbar scoliosis.