Multilevel extended posterior column osteotomy plus unilateral cage strutting for degenerative lumbar kyphoscoliosis

To explore the surgical outcome of patients with degenerative lumbar kyphoscoliosis who underwent multilevel extended posterior column osteotomy (PCO) plus unilateral cage strutting (UCS).

From Jan 2012 to Aug 2017, 23 patients with degenerative lumbar kyphoscoliosis who underwent multilevel extended PCO plus UCS technique (study group) and 13 patients who underwent asymmetrical pedicle subtraction osteotomy (PSO) technique (control group) were retrospectively reviewed; the radiological features, including coronal/sagittal deformity, and clinical evaluation including Oswestry Disability Index (ODI), visual analog scale (VAS), and Japanese Orthopedic Association (JOA) scores-lumbar were assessed before surgery and at follow-up.

All patients underwent the operation successfully. There was no difference in fusion level, blood loss, and follow-up duration between the two groups; the operation time and length of hospital stay were shorter in study group than that in control group. All patients achieved significant correction of both scoliotic and kyphotic deformity and maintained the correction at minimum of two year follow-up, without any difference in deformity correction and correction loss between the two groups. All patients got back pain and leg pain alleviation and neurological function improvement at two year follow-up, without any difference between the two groups. The incidence of complications was lower in study group than that in control group.

Multilevel extended PCO plus UCS procedure could achieve significant correction of scoliosis and kyphosis in the treatment of degenerative lumbar kyphoscoliosis, presenting less surgery time, lower incidence of complication, and shorter hospital stay when compared with the asymmetric PSO technique.