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Adult scoliosis has a Cobb angle greater than 10°
.
The underlying causes of scoliosis range from degenerative disc disease with facet joint hypertrophy to secondary deformities associated with bone disease, hip pathology, and lower extremities or progression of untreated juvenile scoliosis
.
Patients with thoracolumbar scoliosis end up primarily suffering from lower back pain with symptoms of leg limp and localized pain
Thus, the treatment and long-term management of adult degenerative scoliosis is a major challenge, and recent attempts have been made to expand the scope of surgery to include less invasive techniques for the patient, such as neuromodulation, especially spinal cord stimulation (SCS)
.
Quality of life article published in Neuromodulation: Technology at the Neural Interface
Eighteen adult patients with scoliosis who underwent SCS at the Neurosurgery of Charité Hospital between February 2019 and May 2020 were prospectively analyzed
.
A pulse generator is implanted in the hip or abdomen
.
Lead and pulse generator implant placement is selected on a case-by-case basis based on patient-specific complaints and preferences
.
SF-36 Pittsburgh Sleep Quality Index
Case description
.
A 71-year-old post-implantation patient with SCS
.
Initial NRS at rest at preoperative LBP was significantly lower after SCS (three months (45% reduction, p=0.
005) and six months (43% reduction, p=0.
009))
At 6-month follow-up, disappearance of thoracic kyphosis and increased incidence of pelvis were associated with adverse NRS responses to SCS stimulation
Follow-up to 12 months The months after implantation are currently only available for 8 patients
Lucia, K.
Lucia, K.
, Nulis, S.
, Tkatschenko, D.
, Kuckuck, A.
, Vajkoczy, P.
and Bayerl, S.
(2021), Spinal Cord Stimulation: A Reasonable Alternative Treatment in Patients With Symptomatic Adult Scoliosis for Whom Surgical Therapy Is Not Suitable? A Pilot Study .
Neuromodulation: Technology at the Neural Interface, 24: 1370-1376.
A Reasonable Alternative Treatment in Patients With Symptomatic Adult Scoliosis for Whom Surgical Therapy Is Not Suitable? A Pilot Study https://doi.
org/10.
1111/ner.
13351
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