Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics10810.21823/2311-2905-2014-0-4-15-24ReviewsОбзорыReviewsTopical issues of treatment of degenerate scoliosis at adults at the present stage (review)Актуальные вопросы лечения дегенеративного сколиоза на современном этапе (обзор зарубежной литературы)MikhaylovD. A.МихайловД. А.
Russian Federation
dim.m.a@mail.ruPtashnikovD. A.ПташниковД. А.
Russian Federation
UsikovV. D.УсиковВ. Д.
Russian Federation
MasevninS. V.МасевнинС. В.
Russian Federation
HaoM.ХаоМ.
Russian Federation
Vreden Russian Research Institute of Traumatology and OrtopedicsФГБУ «Российский научно-исследовательский институт травматологии и ортопедии им. Р.Р. Вредена» Минздрава РоссииMechnikov North-Western State Medical UniversityГБОУ ВПО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России12122014204127134120920162014https://journal.rniito.org/jour/article/view/108

Degenerative scoliosis is a prevalent issue among the aging population. Controversy remains over the role of surgical intervention in patients with this disease. Authors carry out the review of literature data, consider various approaches of surgical treatment depending on a stage of a disease and extent of deformation, including a decompression, instrumented posterior spinal fusion, an anterior spinal fusion, and osteotomy. These treatment options are based on clinical analysis, radiographic analysis of the mechanical stability of the deformity, given pain generators, and necessary sagittal balance. The high potential complication rates appear to be outweighed by the eventual successful clinical outcomes in patients suitable for operative intervention. This approach has had favorable outcomes and could help resolve the controversy.

Дегенеративный сколиоз - распространенная проблема среди стареющего населения. Противоречие остается в роли и объеме хирургического вмешательства у пациентов с данной патологией. Авторы проводят обзор литературных данных, рассматривают различные подходы хирургического лечения в зависимости от стадии заболевания и степени деформации, включая декомпрессию, спондилосинтез, остеотомию. Эти варианты лечения основаны на анализе клинической картины, механической стабильности деформации, причинах возникновения боли и необходимого сагиттального баланса. Высокие потенциальные риски осложнений, кажется, перевешиваются возможные успешные исходы болезни у пациентов, которым показано оперативное вмешательство. Рассмотренные подходы к лечению имели благоприятные результаты и могут помочь разрешить противоречия.

дегенеративный сколиоз у взрослыхостеотомиядеформация позвоночникасагиттальный балансadults degenerate scoliosisosteotomyspine deformitysagittal balanceAhn U.M., Ahn N.U., Buchowski J.M., Kebaish K.M., Lee J.H., Song E.S. et al. Functional outcome and radiographic correction after spinal osteotomy. Spine. 2002; 27:1303-1311.Albert T.J., Purtill J., Mesa J., McIntosh T., Balderston R.A. Health outcome assessment before and after adult deformity surgery. A prospective study. Spine. 1995; 20:2002-2005.Baron E.M., Albert T.J. Medical complications of surgical treatment of adult spinal deformity and how to avoid them. Spine. 2006;31, 19 Suppl.:S106-S118.Benner B., Ehni G. Degenerative lumbar scoliosis. Spine. 1979;4:548-552.Bernhardt M., Bridwell K.H. Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction. Spine. 1989; 14:717-721.Bradford D.S., Tribus C.B: Vertebral column resection for the treatment of rigid coronal decompensation. Spine. 1997;22:1590-1599.Bridwell K.H., Lenke L.G. Prevention and treatment of decompensation. When can levels be saved and selective fusion be performed in idiopathic scoliosis. Farcy JPC: Complex spinal deformities, Spine: State of the Art Reviews, Vol. 8, No. 3 Philadelphia, Hanley and Belfus, 1994. 643-657Bridwell K.H., Lenke L.G., Baldus C., Blanke K. Major intraoperative neurologic deficits in pediatric and adult spinal deformity patients. Incidence and etiology at one institution. Spine. 1998; 23:324-331.Bridwell K.H. Selection of instrumentation and fusion levels for scoliosis: where to start and where to stop. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J. Neurosurg. Spine. 2004;1:1-8.Bridwell K.H., Lewis S.J., Rinella A., Lenke L.G., Baldus C., Blanke K. Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. Surgical technique. J. Bone Joint Surg. Am. 2004;86-A, Suppl. 1:44-50.Bridwell K.H., Heary R.F. Adult spinal deformity revision surgery. In: Albert T.J. Spinal deformity: the essentials. New York: Thieme; 2007. p. 240-248.Cobb J.R. Outline for the study of scoliosis. Instructional course lectures. American Academy of Orthopedic Surgeons. 1948; 5:261-275.Dakwar E., Cardona R.F., Smith D.A., Uribe J.S. Early outcomes and safety of the minimally invasive, lateral retroperitoneal transpsoas approach for adult degenerative scoliosis. Neurosurg. Focus. 2010; 28 (3): E8.DeWald CJ, Stanley T. Instrumentation-related complications of multilevel fusions for adult spinal deformity patients over age 65: surgical considerations and treatment options in patients with poor bone quality. Spine 1. 2006;31:144-151Deyo R.A., Mirza S.K., Martin B.T., Krenter W. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA. 2010; 303(13): 1259-1265.Everett C.R., Patel R.K. A systematic literature review of nonsurgical treatment in adult scoliosis. Spine. 2007; 32. 19 Suppl.:S130-S134.Grubb S.A., Lipscomb H.J., Coonrad R.W. Degenerative adult onset scoliosis. Spine. 1988; 13:241-245.Grubb S.A., Lipscomb H.J., Suh P.B. Results of surgical treatment of painful adult scoliosis. Spine. 1994; 19:1619-1627.Hosogane N., Watanabe K., Kono H., Saito M., Toyama Y., Matsumoto M. Curve progression after decompression surgery in patients with mild degenerative scoliosis. J. Neurosurg. Spine. 2013; 18(4):321-326.Jackson R.P., Peterson M.D., McManus A.C., Hales C. Compensatory spinopelvic balance over the hip axis and better reliability in measuring lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients. Spine. 1998; 23:1750-1767.Kobayashi T., Atsuta Y., Takemitsu M., Matsuno T., Takeda N. A prospective study of de novo scoliosis in a community based cohort. Spine. 2006; 31:178-182.Korovessis P., Piperos G., Sidiropoulos P., Dimas A. Adult idiopathic lumbar scoliosis. A formula for prediction of progression and review of the literature. Spine. 1994; 19:1926-1932.Kuklo T.R., Bridwell K.H., Lewis S.J., Baldus C., Blanke K., Iffrig T.M. et al. Minimum 2-year analysis of sacropelvic fixation and L5-S1 fusion using S1 and iliac screws. Spine. 2001; 26:1976-1983.Lenke L.G., Bridwell K.H. Achieving coronal balance using Cotrel-Dubousset instrumentation (C-D.I.). In: 8th Proceeding of the International Congress on Cotrel-Dubousset Instrumentation. Montpellier, France, Sauramps Medical Publishers, 1991. p. 27-32.Lenke L.G., O'Leary P.T., Bridwell K.H., Sides B.A., Koester L.A., Blanke K.M. Posterior vertebral column resection for severe pediatric deformity: minimum two-year follow-up of thirty-five consecutive patients. Spine. 2009; 34:2213-2221.Lippman С.R., Spence C.A., Youssef S.A., Cahill D.W. Correction of adult scoliosis via a posterior-only approach. Neurosurg. Focus. 2003; 14 (1):1-6.O'Brien M.F., Kuklo T.R., Blanke K.M., Lenke L.G. Adult deformity. In: Spinal deformity study group radiographic measurements manual. Memphis; 2004. p. 71-94.Ondra S.L., Marzouk S., Koski T., Silva F., Salehi S. Mathematical calculation of pedicle subtraction osteotomy size to allow precision correction of fixed sagittal deformity. Spine. 2006; 31:E973-E979.Ploumis A., Transfledt E.E., Denis F. Degenerative lumbar scoliosis associated with spinal stenosis. Spine J. 2007;7:428-436.Pritchett J.W., Bortel D.T. Degenerative symptomatic lumbar scoliosis. Spine. 1993; 18:700-703.Riseborough E.J. Scoliosis in adults. Curr. Pract. Orthop. Surg. 1977;7:36-55.Robin G.C., Span Y., Steinberg R., Makin M., Menczel J. Scoliosis in the elderly: a follow-up study. Spine. 1982; 7:355-359.Schwab F.J., Smith V.A., Biserni M., Gamez L., Farcy J.P., Pagala M. Adult scoliosis: a quantitative radiographic and clinical analysis. Spine. 2002; 27:387-392.Silva F.E., Bridwell K.H., Lenke L.G. Thoracic Smith-Petersen osteotomy versus pedicle subtraction osteotomy for posterioronly treatment of thoracic kyphosis. In: Mummaneni P.V., Lenke L.G., Haid R.W. Jr. Spinal Deformity. A guide to surgical planning and management. St. Louis: Quality Medical Publishing; 2008. p. 409-428.Van Dam B.E. Nonoperative treatment of adult scoliosis. Orthop. Clin. North. Am. 1988;19:347-351.Vanderpool D.W., James J.I., Wynne-Davies R. Scoliosis in the elderly. J. Bone Joint Surg. Am. 1969; 51:446-455.Williams E.L. Postoperative blindness. Anesthesiol. Clin. North America. 2002; 20:605-622.Zeng Y., White A.P., Albert T.J., Chen Z. Surgical strategy in adult lumbar scoliosis: the utility of categorization into 2 groups based on primary symptom, each with 2-year minimum follow-up. Spine. 2012; 37 (9):E556-E561.