الفهرس 
Anatomy and biomechanics of the lumbar spineOnly 14 pages are availabe for public view
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Abstract
Background: When a patient’s general condition is taken into account, long-segment fusion may not necessarily be the best approach for degenerative scoliosis management. Often, a patient’s symptoms may be alleviated by short segment decompression and fusion surgery that is limited to the upper and lower vertebral boundaries of the scoliotic region. In osteoporotic patients studies reported good functional outcomes and very low revision rates with polymethylmethacrylate augmented screws.
Aim of the Work: This study aims to evaluate the clinical and radiological outcomes of short segment fixation for degenerative scoliosis in osteoporotic patients using augmented screws.
Patients and Methods: This is a prospective Case series study carried out at Ain Shams University hospitals which included 23 patients resistant back pain and lower limb claudication pain not relieved by medical treatment or physical therapy for at least 6 months. All cases managed with Posterior decompression and short segment fixation using pedicle screws augmented with cement (PMMA).
Results: As regards the VAS for leg pain, it showed improvement from 7.18 (± 0.07) to 1.91 (± 0.14). The VAS for back pain also improved from preoperatively 8.17 (± 0.11) to postoperatively 2.52 (± 0.24). As regards the ODI score, there was a significant decrease in the ODI scores from pre-surgery 68.09 (± 1.13) to 12 months post-surgery 25.57 (± 2.02). The Cobb angle decreased dramatically from pre-operative 15.9 (± 0.57) to post-operative, and then increased slightly but remained stable at 6 and 12 months with mean value at last follow up 4.85 (± 0.45). We did not have nonunion cases but only 3 delayed union cases at 6 months and was full united at 12 months that assessed by continuity of osseous bridging between transverse processes in plain X rays and CT scan. compared to similar published literatures This study technique has average blood loss, operation time and hospital stay and decrease the need for revision surgery but with increased hazards of high intraoperative radiation exposure.
Conclusion: Short segment fixation using augmented screws showed a very good clinical outcome in management of degenerative scoliosis with osteoporosis as regards VAS for back pain, VAS for leg pain and ODI score. According to radiological parameters it showed a good result in cobb angle correction, fusion rate, screws and construct stability after 1 year follow up, less pedicle screw loosening and less rate of revision surgery.