RESEARCH PROGRESS OF SURGICAL SELECTION OF FUSION LEVELS FOR DEGENERATIVE SCOLIOSIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHANGZhenguo ^1,2 ,  LIYongmin ²

1. Graduate School of North China University of Science and Technology, Tangshan Hebei, 063000, P. R. China;
2. The First Department of Spinal Surgery, the Second Hospital of Tangshan;

Corresponding?author：

LIYongmin, Email: 2008.liyongmin@163.com

Keywords：

Degenerative scoliosis; Interbody fusion; Fusion level

DOI：

10.7507/1002-1892.20160209

Video：

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Objective To summarize the progress of the surgical selection of fusion levels for degenerative scoliosis. Methods The domestic and foreign related literature about degenerative scoliosis, including clinical features, classification, surgical treatment, and the fused segment, was summarized. Results Degenerative scoliosis is very complicated. Short segment fusion and long segment fusion are the main surgical types. The long segment fusion is better in terms of reconstructing the stability of spine; however, it has more related complications. The short segment fusion has been used widely in clinical, but it causes degenerative disease easily. W/AL value can be used to direct the selection of short or long segment fusion for degenerative scoliosis. Conclusion The key to success surgery is choosing reasonable fused segment. Now there is no unified selection standard. With more knowledge about degenerative scoliosis, greater development can be expected in the future.

Citation： SHANGZhenguo, LIYongmin. RESEARCH PROGRESS OF SURGICAL SELECTION OF FUSION LEVELS FOR DEGENERATIVE SCOLIOSIS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(8): 1044-1048. doi: 10.7507/1002-1892.20160209 Copy

1.	Palmisani M, Dema E, Cervellati S. Surgical treatment of adult degenerative scoliosis. Eur Spine J, 2014, 22 Supplement 6:829-833.
2.	馬信龍, 徐寶山.成人退變性脊柱側凸的診斷和治療策略.中華骨科雜志, 2012, 32(8):796-802.
3.	Xu L, Sun X, Huang S, et al. Degenerative lumbar scoliosis in Chinese Han population:prevalence and relationship to age, gender, bone mineral density, and body mass index. Eur Spine J, 2013, 22(6): 1326-1331.
4.	Hong JY, Suh SW, Modi HN, et al. The prevalence and radiological findings in 1347 elderly patients with scoliosis. J Bone Joint Surg (Br), 2010, 92(7):980-983.
5.	Kebaish KM, Neubauer PR, Voros GD, et al. Scoliosis in adults aged forty years and older:prevalence and relationship to age, race, and gender. Spine (Phila Pa 1976), 2011, 36(9):731-736.
6.	邱勇.退變性與特發性成人脊柱側凸的影像學鑒別及其意義.中國脊柱脊髓雜志, 2011, 21(1):9-10.
7.	Cho KJ, Kim YT, Shin SH, et al. Surgical treatment of adult degenerative scoliosis. Asian Spine J, 2014, 8(3):371-381.
8.	Seo JY, Ha KY, Hwang TH, et al. Risk of progression of degenerative lumbar scoliosis. J Neurosurg Spine, 2011, 15(5):558-566.
9.	宋海峰, 邱貴興, 王以朋, 等.退變性脊柱側凸的臨床特點與影像學分析.中國脊柱脊髓雜志, 2008, 18(3):201-205.
10.	Weinstein SL, Dolan LA, Cheng JC, et al. Adolescent idiopathic scoliosis. Lancet, 2008, 371(9623):1527-1537.
11.	Glassman SD, Keith B, Dimar JR, et al. The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976), 2005, 30(18):2024-2029.
12.	賈梓, 宋云龍, 李相生, 等. 640層動態容積CT腰椎連續運動掃描的初步探討.中國醫學工程, 2012, 20(1):50-51.
13.	Cho KJ, Suk SI, Park SR, et al. Short fusion versus long fusion for degenerative lumbar scoliosis. Eur Spine J, 2008, 17(5):650-656.
14.	Schwab FJ, Smith VA, Biserni M, et al. Adult scoliosis:a quantitative radiographic and clinical analysis. Spine (Phila Pa 1976), 2002, 27(4): 387-932.
15.	Toyone T, Tanaka T, Kato D, et al. Anatomic changes in lateral spondylolisthesis associated with adult lumbar scoliosis. Spine (Phila Pa 1976), 2005, 30(22):E671-675.
16.	Kobayashi T, Atsuta YM, Matsuno T, et al. A prospective study of de novo scoliosis in a community based cohort. Spine (Phila Pa 1976), 2006, 31(2):178-182.
17.	吳增暉, 馬向陽, 章凱, 等.退行性腰椎側凸的外科治療.中國骨科臨床與基礎研究雜志, 2013, 5(4):221-225.
18.	Lowe T, Berven SH, Schwab FJ, et al. The SRS classification for adult spinal deformity:building on the King/Moe and Lenke classification systems. Spine (Phila Pa 1976), 2006, 31(19 Suppl):S119-125.
19.	Ploumis A, Transfledt EE, Denis F. Degenerative lumbar scoliosis associated with spinal stenosis. Spine J, 2007, 7(4):428-436.
20.	Simmons ED. Surgical treatment of patients with lumbar spinal stenosis with associated scoliosis. Clin Orthop Relat Res, 2001, (384): 45-53.
21.	劉洪, 米川, Ploumis A, 等.成人退變性腰椎側凸的分型及手術方法選擇.中國矯形外科雜志, 2010, 18(1):22-25.
22.	邱勇, 王斌, 朱鋒, 等.退變性腰椎側凸的冠狀面失衡分型及對截骨矯形術式選擇的意義.中華骨科雜志, 2009, 29(5):418-423.
23.	Silva FE, Lenke LG. Adult degenerative scoliosis:evaluation and management. Neurosurg Focus, 2010, 28(3):E1.
24.	Bridwell KH. Selection of instrumentation and fusion levels for scoliosis:where to start and where to stop. J Neurosurg Spine, 2004, 1(1):1-8.
25.	Mok JM, Hu SS. Surgical strategies and choosing levels for spinal deformity:how high, how low, front and back. Neurosurg Clin North Am, 2007, 18(2):329-337.
26.	Yang SH, Chen PQ. Proximal kyphosis after short posterior fusion for thoracolumbar scoliosis. Clin Orthop Relat Res, 2003, (411):152-158.
27.	鄒德波, 周東生, 張凱寧, 等.成人退行性脊柱側凸的研究進展.中國矯形外科雜志, 2011, 18(15):1270-1272.
28.	Shufflebarger H, Suk SI, Mardjetko S. Debate:determining the upper instrumented vertebra in the management of adult degenerative scoliosis. Spine (Phila Pa 1976), 2006, 31(19 Suppl):S185-194.
29.	Cho KJ, Suk SI, Park SR, et al. Selection of proximal fusion level for adult degenerative lumbar scoliosis. Eur Spine J, 2013, 22(2):394-401.
30.	Zhu Y, Wang K, Wang B, et al. Selection of proximal fusion level for degenerative scoliosis and the entailing proximal-related late complications. Int J Clin Exp Med, 2015, 8(4):5731-5738.
31.	Kuklo TR. Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves. Spine (Phila Pa 1976), 2006, 31(19 Suppl):S132-138.
32.	Edwards CC 2nd, Bridwell KH, Patel A, et al. Thoracolumbar deformity arthrodesis to L5 in adults:the fate of the L5-S1 disc. Spine (Phila Pa 1976), 2003, 28(18):2122-2131.
33.	Polly DW Jr, Hamill CL, Bridwell KH. Debate:to fuse or not to fuse to the sacrum, the fate of the L5-S1 disc. Spine, 2006, 31(19 Suppl): S179-S184.
34.	Bridwell KH, Edwards CC 2nd, Lenke LG. The pros and cons to saving the L5-S1 motion segment in a long scoliosis fusion construct. Spine, 2003, 28(20):S234-242.
35.	Good CR, Lenke LG, Bridwell KH, et al. Can posterior-only surgery provide similar radiographic and clinical results as combined anterior (thoracotomy/thoracoabdominal)/posterior approaches for adult scoliosis? Spine (Phila Pa 1976), 2010, 35(2):210-218.
36.	Yagi M, Hosogane N, Okada E, et al. Factors affecting the postoperative progression of thoracic kyphosis in surgically treated adult patients with lumbar degenerative scoliosis. Spine (Phila Pa 1976), 2014, 39(8):E521-528.
37.	Kim YJ, Bridwell KH, Lenke LG, et al. Pseudarthrosis in primary fusions for adult idiopathic scoliosis:incidence, risk factors, and outcome analysis. Spine, 2005, 30(4):468-474.
38.	Marchesi DG, Aebi M. Pedicle fixation devices in the treatment of adult lumbar scoliosis. Spine, 1992, 17(8 Suppl):304-309.
39.	Gupta MC. Degenerative scoliosis. Options for surgical management. Orthop Clin North Am, 2003, 34(2):269-279.
40.	Bernhardt M, Bridwell KH. Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction. Spine (Phila Pa 1976), 1989, 14(7):717-721.
41.	Li CD, Sun HL, Lu HZ. Comparison of the effect of posterior lumbar interbody fusion with pedicle screw fixation and interspinous fixation on the stiffness of adjacent segments. Chin Med J, 2013, 126(9):1732-1737.
42.	劉胄, 趙慶華, 吳興洲, 等.短節段與長節段固定融合在退變性腰椎側凸合并腰椎管狹窄癥治療的效果觀察.中華醫學雜志, 2012, 92(25):1751-1755.
43.	Sansur CA, Smith JS, Coe JD, et al. Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976), 2011, 36(9):E593-597.
44.	Lewis SJ, Harith A, Chua S, et al. Upper instrumented vertebral fractures in long lumbar fusions:what are the associated risk factors? Spine (Phila Pa 1976), 2012, 37(16):1407-1414.
45.	王乃國, 王以朋, 邱貴興, 等.短節段融合對退變性腰椎側凸鄰近節段椎間角的影響.中華外科雜志, 2010, 48(7):506-510.
46.	Jiang CJ, Yang YJ, Zhou JP, et al. Applications of the scoliosis widthto-length ratio for guiding selection of the surgical approaches of degenerative lumbar scoliosis. BMC Musculoskeletal Disorders, 2016, 17:48.

1. Palmisani M, Dema E, Cervellati S. Surgical treatment of adult degenerative scoliosis. Eur Spine J, 2014, 22 Supplement 6:829-833.
2. 馬信龍, 徐寶山.成人退變性脊柱側凸的診斷和治療策略.中華骨科雜志, 2012, 32(8):796-802.
3. Xu L, Sun X, Huang S, et al. Degenerative lumbar scoliosis in Chinese Han population:prevalence and relationship to age, gender, bone mineral density, and body mass index. Eur Spine J, 2013, 22(6): 1326-1331.
4. Hong JY, Suh SW, Modi HN, et al. The prevalence and radiological findings in 1347 elderly patients with scoliosis. J Bone Joint Surg (Br), 2010, 92(7):980-983.
5. Kebaish KM, Neubauer PR, Voros GD, et al. Scoliosis in adults aged forty years and older:prevalence and relationship to age, race, and gender. Spine (Phila Pa 1976), 2011, 36(9):731-736.
6. 邱勇.退變性與特發性成人脊柱側凸的影像學鑒別及其意義.中國脊柱脊髓雜志, 2011, 21(1):9-10.
7. Cho KJ, Kim YT, Shin SH, et al. Surgical treatment of adult degenerative scoliosis. Asian Spine J, 2014, 8(3):371-381.
8. Seo JY, Ha KY, Hwang TH, et al. Risk of progression of degenerative lumbar scoliosis. J Neurosurg Spine, 2011, 15(5):558-566.
9. 宋海峰, 邱貴興, 王以朋, 等.退變性脊柱側凸的臨床特點與影像學分析.中國脊柱脊髓雜志, 2008, 18(3):201-205.
10. Weinstein SL, Dolan LA, Cheng JC, et al. Adolescent idiopathic scoliosis. Lancet, 2008, 371(9623):1527-1537.
11. Glassman SD, Keith B, Dimar JR, et al. The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976), 2005, 30(18):2024-2029.
12. 賈梓, 宋云龍, 李相生, 等. 640層動態容積CT腰椎連續運動掃描的初步探討.中國醫學工程, 2012, 20(1):50-51.
13. Cho KJ, Suk SI, Park SR, et al. Short fusion versus long fusion for degenerative lumbar scoliosis. Eur Spine J, 2008, 17(5):650-656.
14. Schwab FJ, Smith VA, Biserni M, et al. Adult scoliosis:a quantitative radiographic and clinical analysis. Spine (Phila Pa 1976), 2002, 27(4): 387-932.
15. Toyone T, Tanaka T, Kato D, et al. Anatomic changes in lateral spondylolisthesis associated with adult lumbar scoliosis. Spine (Phila Pa 1976), 2005, 30(22):E671-675.
16. Kobayashi T, Atsuta YM, Matsuno T, et al. A prospective study of de novo scoliosis in a community based cohort. Spine (Phila Pa 1976), 2006, 31(2):178-182.
17. 吳增暉, 馬向陽, 章凱, 等.退行性腰椎側凸的外科治療.中國骨科臨床與基礎研究雜志, 2013, 5(4):221-225.
18. Lowe T, Berven SH, Schwab FJ, et al. The SRS classification for adult spinal deformity:building on the King/Moe and Lenke classification systems. Spine (Phila Pa 1976), 2006, 31(19 Suppl):S119-125.
19. Ploumis A, Transfledt EE, Denis F. Degenerative lumbar scoliosis associated with spinal stenosis. Spine J, 2007, 7(4):428-436.
20. Simmons ED. Surgical treatment of patients with lumbar spinal stenosis with associated scoliosis. Clin Orthop Relat Res, 2001, (384): 45-53.
21. 劉洪, 米川, Ploumis A, 等.成人退變性腰椎側凸的分型及手術方法選擇.中國矯形外科雜志, 2010, 18(1):22-25.
22. 邱勇, 王斌, 朱鋒, 等.退變性腰椎側凸的冠狀面失衡分型及對截骨矯形術式選擇的意義.中華骨科雜志, 2009, 29(5):418-423.
23. Silva FE, Lenke LG. Adult degenerative scoliosis:evaluation and management. Neurosurg Focus, 2010, 28(3):E1.
24. Bridwell KH. Selection of instrumentation and fusion levels for scoliosis:where to start and where to stop. J Neurosurg Spine, 2004, 1(1):1-8.
25. Mok JM, Hu SS. Surgical strategies and choosing levels for spinal deformity:how high, how low, front and back. Neurosurg Clin North Am, 2007, 18(2):329-337.
26. Yang SH, Chen PQ. Proximal kyphosis after short posterior fusion for thoracolumbar scoliosis. Clin Orthop Relat Res, 2003, (411):152-158.
27. 鄒德波, 周東生, 張凱寧, 等.成人退行性脊柱側凸的研究進展.中國矯形外科雜志, 2011, 18(15):1270-1272.
28. Shufflebarger H, Suk SI, Mardjetko S. Debate:determining the upper instrumented vertebra in the management of adult degenerative scoliosis. Spine (Phila Pa 1976), 2006, 31(19 Suppl):S185-194.
29. Cho KJ, Suk SI, Park SR, et al. Selection of proximal fusion level for adult degenerative lumbar scoliosis. Eur Spine J, 2013, 22(2):394-401.
30. Zhu Y, Wang K, Wang B, et al. Selection of proximal fusion level for degenerative scoliosis and the entailing proximal-related late complications. Int J Clin Exp Med, 2015, 8(4):5731-5738.
31. Kuklo TR. Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves. Spine (Phila Pa 1976), 2006, 31(19 Suppl):S132-138.
32. Edwards CC 2nd, Bridwell KH, Patel A, et al. Thoracolumbar deformity arthrodesis to L5 in adults:the fate of the L5-S1 disc. Spine (Phila Pa 1976), 2003, 28(18):2122-2131.
33. Polly DW Jr, Hamill CL, Bridwell KH. Debate:to fuse or not to fuse to the sacrum, the fate of the L5-S1 disc. Spine, 2006, 31(19 Suppl): S179-S184.
34. Bridwell KH, Edwards CC 2nd, Lenke LG. The pros and cons to saving the L5-S1 motion segment in a long scoliosis fusion construct. Spine, 2003, 28(20):S234-242.
35. Good CR, Lenke LG, Bridwell KH, et al. Can posterior-only surgery provide similar radiographic and clinical results as combined anterior (thoracotomy/thoracoabdominal)/posterior approaches for adult scoliosis? Spine (Phila Pa 1976), 2010, 35(2):210-218.
36. Yagi M, Hosogane N, Okada E, et al. Factors affecting the postoperative progression of thoracic kyphosis in surgically treated adult patients with lumbar degenerative scoliosis. Spine (Phila Pa 1976), 2014, 39(8):E521-528.
37. Kim YJ, Bridwell KH, Lenke LG, et al. Pseudarthrosis in primary fusions for adult idiopathic scoliosis:incidence, risk factors, and outcome analysis. Spine, 2005, 30(4):468-474.
38. Marchesi DG, Aebi M. Pedicle fixation devices in the treatment of adult lumbar scoliosis. Spine, 1992, 17(8 Suppl):304-309.
39. Gupta MC. Degenerative scoliosis. Options for surgical management. Orthop Clin North Am, 2003, 34(2):269-279.
40. Bernhardt M, Bridwell KH. Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction. Spine (Phila Pa 1976), 1989, 14(7):717-721.
41. Li CD, Sun HL, Lu HZ. Comparison of the effect of posterior lumbar interbody fusion with pedicle screw fixation and interspinous fixation on the stiffness of adjacent segments. Chin Med J, 2013, 126(9):1732-1737.
42. 劉胄, 趙慶華, 吳興洲, 等.短節段與長節段固定融合在退變性腰椎側凸合并腰椎管狹窄癥治療的效果觀察.中華醫學雜志, 2012, 92(25):1751-1755.
43. Sansur CA, Smith JS, Coe JD, et al. Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976), 2011, 36(9):E593-597.
44. Lewis SJ, Harith A, Chua S, et al. Upper instrumented vertebral fractures in long lumbar fusions:what are the associated risk factors? Spine (Phila Pa 1976), 2012, 37(16):1407-1414.
45. 王乃國, 王以朋, 邱貴興, 等.短節段融合對退變性腰椎側凸鄰近節段椎間角的影響.中華外科雜志, 2010, 48(7):506-510.
46. Jiang CJ, Yang YJ, Zhou JP, et al. Applications of the scoliosis widthto-length ratio for guiding selection of the surgical approaches of degenerative lumbar scoliosis. BMC Musculoskeletal Disorders, 2016, 17:48.

Chinese Journal of Reparative and Reconstructive Surgery

RESEARCH PROGRESS OF SURGICAL SELECTION OF FUSION LEVELS FOR DEGENERATIVE SCOLIOSIS

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