Cortical bone trajectory and traditional trajectory combined with satellite rod fixation for degenerative scoliosis

English Keywords:Degenerative scoliosis  Long segment fixation  Cortical bone trajectory  Traditional trajectory  Satellite rods

English Abstract:

  【Abstract】 Objectives: To explore the feasibility and clinical outcomes of cortical bone trajectory(CBT) and traditional trajectory(TT) combined with satellite rod which terminated to S1 in patients with adult degenerative scoliosis(ADS). Methods: This retrospective study included patients with ADS who underwent CBT+TT combining with satellite rods long fusion, from June 2014 to January 2018. Visual analogue score(VAS), the Oswestry disability index(ODI), Cobb angle, the distance between C7 plumb line and center sacral vertical line(C7PL-CSVL) and sagittal vertebral axis(SVA ) were compared among before operation, immediately after operation and at final follow-up. Results: A toal of 11 patients were enrolle, all of them were female with an average age of 64.36±7.63 years. The operation time was 247.64±44.96min, and the blood loss was 1118.18±464.37ml. Cerebrospinal fluid leakage occurred in 1 patient, and the wound healed well after prolonged drainage and dressing change. 1 patient showed transient muscle weakness after surgery, and was given mecobalamine for 2 weeks, who recovered three months after the operation. No serious complication occurred. The mean follow-up time was 33.87±14.36 months. VAS score was 7.00±0.89 points before surgery and 0.91±0.70 points at the last of follow-up. The ODI was (51.09±7.83)% at the initial examination and (5.45±1.13)% at the final follow-up. The Cobb angle decreased from 49.10°±11.51° preoperatively to 12.05°±3.78 immediately after operation and 13.06°±3.38 at the last of follow-up. C7PL-CSVL was 27.27±17.61mm, 12.20±8.04mm and 2.40±8.05mm preoperatively, immediately after operation and at the last follow-up respectively. SVA was 25.33±18.21mm, 8.60±5.31mm and 9.75±6.94mm preoperatively, immediately after operation and at the end follow-up respectively. There were significant differences of Cobb angle, C7PL-CSVL and SVA between before operation and at the final follow-up(P＜0.05), but there was no statistical significance difference of the above three measurements between immediately after operation and at the final follow-up(P＞0.05). All patients had no failure of instrument. Conclusions: CBT and TT combined with satellite rod which terminated to S1 has a good short and mid term outcomes in ADS, and provides a new reliable measure to enhance fixation of spine and pelvis.