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Published byLaurence Phillips Modified over 9 years ago
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Degenerative scoliosis requires full deformity correction The argument against Evan Davies
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2010
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The French Conspiracy
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Complication rate 39% Risk Factors – No of levels – Fusion to sacrum – PSO 44% reoperation in 6 years
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Upper thoracic fusions – More blood – 100% more complications – 400% higher pseudoarthrosis – 100% more revisions NO DIFFERENCE IN ODI SRS WORSE IN LONG FUSIONS
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How do your patients look in clinic?
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What are we treating? – X-ray – Back Pain – Sagittal or coronal imbalance – Neurogenic claudication/radiculopat hy
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Cobb angle unchanged in decompression and limited fusion, 50% change in fusion Complications – Full fusion 56% – Partial fusion40% – Decompression10%
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SF-36/ODI significant improvement in decompression, limited fusion SF36/ODI no significant improvement in full fusion
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The argument against It Costs More It Hurts More You do worse
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