The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Precision surgical treatment of lumbar spinal stenosis accompanied with degenerative scoliosis under the Quad? rant retractor in the elderly

Author : TENG Hai- jun, GUO Zhi- liang, LU Hai- jiang, et al.     
Working unit : Second Department of Spinal Surgery, The 89th Hospital of PLA , Weifang 261021, China
Page : 416-419
Key words : Quadrant retractor, minimally invasive surgery, lumbar spinal stenosis, degenerative lumbar scoliosis

  Abstract:

Objective

To evaluate the clinical outcome of precision surgical treatment of lumbar spinal stenosis accompanied with degenerative scoliosis under the Quadrant retractor in the elderly.

Methods

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.

Results

All 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.

Conclusion

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.


summary:
Precision surgical treatment of lumbar spinal stenosis accompanied with degenerative scoliosis under the Quad? rant retractor in the elderly   
TENG Hai- jun, GUO Zhi- liang, LU Hai- jiang, et al.
Orthop J Chin,2018,26(5):   416-419