Symptomatic progression of degenerative scoliosis after decompression and limited fusion surgery for lumbar spinal stenosis John K. Houten, Rani Nasser

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Symptomatic progression of degenerative scoliosis after decompression and limited fusion surgery for lumbar spinal stenosis John K. Houten, Rani Nasser Journal of Clinical Neuroscience Volume 20, Issue 4, Pages 613-615 (April 2013) DOI: 10.1016/j.jocn.2012.06.002 Copyright © 2012 Elsevier Ltd Terms and Conditions

Fig. 1 (a) Anterior–posterior and (b) lateral lumbar radiographs in a 59-year-old woman with a history of low back pain demonstrating mild degenerative scoliosis without spondylolisthesis. (c) Sagittal T2-weighted MRI shows a disc herniation migrating down the superior aspect of L4 and moderate stenosis. After a decompressive laminectomy, the patient re-presented with right leg pain and (d) a lateral radiograph showing collapse of the L3/4 disc space with lateral listhesis and worsening of the degenerative scoliotic curve. Journal of Clinical Neuroscience 2013 20, 613-615DOI: (10.1016/j.jocn.2012.06.002) Copyright © 2012 Elsevier Ltd Terms and Conditions

Fig. 2 (a) Anterior–posterior and (b) sagittal reconstructed CT scans of the lumbar spine following a two-level extreme lateral interbody fusion procedure at L3–5 resulting in re-establishment of L3–4 disc space height compared with that seen in Fig. 1, correlating with good clinical relief of symptoms. Journal of Clinical Neuroscience 2013 20, 613-615DOI: (10.1016/j.jocn.2012.06.002) Copyright © 2012 Elsevier Ltd Terms and Conditions

Fig. 3 (a) Anterior–posterior radiograph and (b) coronal reconstructed CT scan approximately 2years following the studies in Fig. 2 showing solid fusion of L3–5 but interval development of severe deformity with collapse of the right side of the L2–3 disc space and lateral listhesis. Following revision surgery that consisted of a transforaminal lumbar interbody fusion at L2–3 and a posterolateral fusion extended to T12, an anterior–posterior radiograph (c) shows the re-establishment of the L2–3 disc space height and improvement of deformity that correlated with marked improvement in clinical symptoms of pain and resolution of motor deficits. Journal of Clinical Neuroscience 2013 20, 613-615DOI: (10.1016/j.jocn.2012.06.002) Copyright © 2012 Elsevier Ltd Terms and Conditions