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Degenerative scoliosis requires full deformity correction The argument against Evan Davies.

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Presentation on theme: "Degenerative scoliosis requires full deformity correction The argument against Evan Davies."— Presentation transcript:

1 Degenerative scoliosis requires full deformity correction The argument against Evan Davies

2 2010

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5 The French Conspiracy

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7 Complication rate 39% Risk Factors – No of levels – Fusion to sacrum – PSO 44% reoperation in 6 years

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9 Upper thoracic fusions – More blood – 100% more complications – 400% higher pseudoarthrosis – 100% more revisions NO DIFFERENCE IN ODI SRS WORSE IN LONG FUSIONS

10 How do your patients look in clinic?

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14 What are we treating? – X-ray – Back Pain – Sagittal or coronal imbalance – Neurogenic claudication/radiculopat hy

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16 Cobb angle unchanged in decompression and limited fusion, 50% change in fusion Complications – Full fusion 56% – Partial fusion40% – Decompression10%

17 SF-36/ODI significant improvement in decompression, limited fusion SF36/ODI no significant improvement in full fusion

18 The argument against It Costs More It Hurts More You do worse

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