Degenerative Lumbar Scoliosis: Revision Rates After Decompression Alone or Decompression and Limited Fusion

Objective: To compare the rates of revision surgery after decompression alone or decompression and limited fusion for treatment of radicular symptoms in patients with degenerative lumbar scoliosis.

Methods: 38 consecutive patients with degenerative scoliosis and radiculopathy treated surgically by one surgeon at one institution with minimum followup of 24 months were studied. Protocol for treatment included decompression for radiculopathy, and the addition of fusion for cases of instability. Instability was defined by degenerative spondylolisthesis and/or lateral listhesis of more than 3 mm.

Results: 21 patients (11 males, average age 70) in the group underwent decompression alone. The average curve pre and post-operatively were 16 and 18 respectively. The average followup was 31 months. Eight patients (38%) underwent revision surgery at an average of 29 months after index procedure. The main reason for surgery was revision decompression at the site of the original surgery. 17 patients (3 males, average age 71) in the group underwent decompression and limited fusion (9 spondylolisthesis, 8 lateral listhesis).The average curve pre and post-operatively were 21 and 19 degrees respectively. The average followup was 39 months. Six patients (36%) underwent revision surgery at an average of 32 months after index procedure. The main reason for surgery was decompression at stenotic site adjacent to index fusion site.

Conclusion: The rates of revision surgery after decompression alone or decompression and limited fusion for treatment of radicular symptoms in patients with degenerative lumbar scoliosis are similar. The reason for revision surgery in the former group is revision decompression and for the latter group is decompression of adjacent segment stenosis.