Analysis of Clinical Effect of Interbody Fusion and Internal Fixation on Degenerative Scoliosis

Abstract

In this study, we analyzed the clinical effect of interbody fusion and internal fixation on degenerative scoliosis. Methods: After degenerative lumbar scoliosis (DLS) surgery, patients were retrospectively evaluated using VAS (Visual Analogue Scale) and ODI (Oswestry Disability Index) to evaluate clinical efficacy. All patients underwent posterior lumbar decompression laminectomy, pedicle screw internal fixation and posterolateral bone graft fusion.Imaging measurements include scoliosis Cobb angle, fusion Cobb angle, intervertebral angle (AIA), sagittal intervertebral angle (SIA), and lumbar lordosis angle. The relationship between these parameters was tested by binary Pearson analysis and linear regression analysis. Results: Before surgery, the Cobb angle of the scoliosis segment was 15.3^°, and it dropped to 10.1^° immediately after the operation (P <0.05). Compared with preoperative and postoperative values (2.4±2.7 and 2.1±2.3, respectively; P <0.05), AIA increased significantly (4.3±3.3) at the last follow-up. However, scoliosis Cobb angle and AIA were not related to VAS or ODI scores. At the final follow-up, no patients developed pseudoarthritis or internal device-related complications. Conclusion: Intervertebral bone fusion and internal fixation resulted in limited DLS correction, and the correction effect decreased over time. The AIA between the upper adjacent segment and the proximal fusion vertebrae continues to increase after surgery, but it does not worsen the clinical symptoms, which is reflected in the lower reoperation rate of the adjacent level of repair recurrence rate.