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Overview of operative modalities and their functional outcomes for adult degenerative scoliosis: How to chose wisely!

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Original Article

Author Details : Ketan S Khurjekar, Himanshu G Kulkarni*, Siddarth Kothari, Shailesh R Hadgaonkar, Ajay R Kothari, Parag K Sancheti

Volume : 8, Issue : 1, Year : 2022

Article Page : 32-38

https://doi.org/10.18231/j.ijos.2022.006

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Abstract

Background: Adult degenerative scoliosis presents with various symptoms, including back pain, leg pain, claudication, and radiological findings like coronal / sagittal imbalance. So In our study, we have put forth an algorithm to categorise the patients for suitable operative management.
Materials and Methods: This was prospective study of 30 patients. Patients with age 50 and above and ones who had no relief/worsening of symptoms after 6 months of conservative management were included. Patients were categorised into 3 groups. Patients were either treated with Focal Decompression / Decompression and long instrumented fusion with correction of deformity /Decompression only. MODI and SF36 scores were compared at the end of 2 years.
Results: 11 patients were categorised into group A, 15 into group B and, 4 patients who had significant co-morbidities and had very high risk for surgery were categorised into group 3. There was significant (p <.001) improvement in average MODI scores in both group A and group B at the end of 2 years. Improvement was seen in average MODI scores of patients in group 3, but it was not statistically significant. SF-36 score showed significant improvement in Group A and group B at the end of 2 years (p <.001). Patients from group 3 also showed improvement in average scores, but that was not significant.
Conclusion: Not every case needs long stabilization, focal decompression only also gives satisfactory outcome in properly selected patients. In patients operated by Instrumented fusion, Sagittal balance also plays a crucial role in functional outcome.
 

Keywords: ADS, DeNovo Scoliosis, Degenerative scoliosis.

How to cite : Khurjekar K S, Kulkarni H G, Kothari S, Hadgaonkar S R, Kothari A R, Sancheti P K, Overview of operative modalities and their functional outcomes for adult degenerative scoliosis: How to chose wisely!. Indian J Orthop Surg 2022;8(1):32-38

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