Abstract

Background: The prevalence of adult degenerative scoliosis increases with age and can appear in a previously aligned column. Its prevalence is from 2 to 32% in people over 50 years of age.

Material and Methods: a prospective, longitudinal, comparative controlled study with two-year follow-up, in adult degenerative scoliosis, divided into two groups Group I treated with posterior approach and Group 2 treated with the double approach. 43 patients with an average age of 63.2 years, 30 women (69.76%), with curves with magnitude from 10 to 42°. 35 were subjected to a posterior approach, while 8 were treated with a double approach (ALPA Anterior-Lateral-Transpsoas-Approach + posterior approach).

Results: the Roland-Morris scale in group 1 was 13.17 (0-22) and at 2 years 9.75 (0-22) for group 2 with a preoperative mean of 14.71 (8-20) and 7.28 (0-14) at 2 years. No statistical significance between groups (p=0.356). The Oswestry in preoperative group 2 patients was 49.71 (26-74); 2 years in 21.85 (2-44). For group 1 in 54.27 (18-82), and 35.51 (2-82) in 2 years. pelvic parameters have no difference and only correction of scoliosis and sagittal balance was better in the double-approach group.

Conclusion: The meta-analysis revealed that CR MB and PS MB could achieve similar clinical outcomes, whereas the rate of complications and revision was significantly increased in CR MB. Based on the outcomes of this meta-analysis, the choice of the CR MB does not appear to be justified, and further studies of high methodological quality with long-term follow-up are required to confirm our conclusion.

Keywords: Degenerative scoliosis; Double lumbar approach; Posterior lumbar approach