The selection of a surgical strategy for the treatment of adult degenerative scoliosis with "pear-shaped" decompression under open spinal endoscopy

• Published in: Scientific reports 2024-07, Vol.14 (1), p.16019-12, Article 16019
• Main Authors: Wang, Hongyan, Liu, Xin, Li, Yuefei, Ren, Jiabin, Sun, Zhaozhong, Sun, Ning, Li, Rui
• Format: Article
• Language: English
• Subjects: 692/1807/410/2610; 692/308/409; 692/700/565/545/379; Adult; Aged; Classification; Decompression; Decompression, Surgical - methods; Endoscopy; Endoscopy - methods; Female; Humanities and Social Sciences; Humans; Leg; Male; Middle Aged; Minimally invasive; multidisciplinary; OSE; Patients; Remission; Remission (Medicine); Retrospective Studies; Science; Science (multidisciplinary); Scoliosis; Scoliosis - classification; Scoliosis - diagnostic imaging; Scoliosis - surgery; Spinal deformity; Spinal stenosis; Spinal Stenosis - diagnostic imaging; Spinal Stenosis - surgery; Surgery; Surgical strategy; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-67003-y

The prognoses of patients who undergo open spinal endoscopy (OSE) decompression significantly differ by scoliosis type and symptom despite the use of uniform standards and procedures for the decompression surgery. These differences may be directly related to the selection and formulation of surgical strategies but their cause remains unclear. The aim of this study was to verify and evaluate the efficacy of the "Symptom, Stenosis and Segment classification (SSS classification)" in determining an appropriate surgical strategy and to analyze the differences in the outcomes of different patients after receiving the selected surgical strategy. The results of this study ultimately provide a theoretical basis for the specific optimization of surgical strategies guided by the "SSS classification". This work was a retrospective study. We reviewed 55 patients with scoliosis and spinal stenosis who underwent "pear-shaped" decompression under OSE from May 2021 to June 2023 treated by our surgical team. To classify different types of patients, we defined the "SSS classification" system. The permutation and combination of subtypes in Symptom (including three subtypes: Convex = v, Concave = c and Bilateral = b), Stenosis (including three subtypes: Convex = v, Concave = c and Bilateral = b), and Segment (including two subtypes: Edge = e and Inside = i) yields 18 possible types (details in Table 1) in this classification system. To classify different types of surgeries, we also defined the operation system. The VAS Back and VAS Leg scores after surgical treatment were significantly lower in all patients 3 months after surgery than before surgery. (**P