Correction with Instrumented Fusion Versus Non-Corrective Surgery for Degenerative Lumbar Scoliosis: A Systematic Review
Akom Prommahachai MD*, Krengkrai Wittayapirot MD*, Kitti Jirarattanaphochai MD, PhD*, Surachai Sae-Jung MD*
Affiliation : * Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : To evaluate the effect of surgical treatment between correction and non-correction surgery for degenerative
lumbar scoliosis by systematic review method.
Material and Method: The database inclusions were PubMed (January 1, 1960 to March 31, 2009), EMBASE (January 1,
1985 to March 31, 2009), The Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and various articles. Grey
literature was searched from Scirus. The quality of the studies was graded by MINORS. Studies that were classified level I to
IV were included in analysis of surgical treatment outcome in degenerative lumbar scoliosis. Patient centered outcomes,
surgical outcomes, and complication were collected. Two reviewers independently assessed trial quality and extracted data.
Results : Seventeen studies were included in analysis comprising 598 patients with degenerative lumbar scoliosis and treated
by operative treatment. Overall, 451 patients received correction procedure. All trials were non-randomized and non-
comparative studies. Almost all level evidence of the study was level III to IV. Overall results were comparable between
correction and non-corrective operation.
Conclusion : There were insufficient good-quality comparative studies for surgical treatment outcome comparing between
corrective deformity and non-corrective procedures. The correction of deformity in degenerative lumbar scoliosis was
classified Level 2C (very weak recommendations).
Keywords : Systematic review, Degenerative Lumbar Scoliosis, Correction, Surgery
