Short-term outcomes of stage II and III Lenke-Silva degenerative scoliosis in osteoporotic patients treated with augmented pedicle screws: A prospective case series study

Objectives: The management of degenerative scoliosis based on the Lenke and Silva classification necessitates careful clinical evaluation. In many cases, a patient’s symptoms can be effectively managed through short-segment decompression and fusion. Among osteoporotic individuals, studies have demonstrated favorable functional outcomes and remarkably low revision rates when utilizing polymethylmethacrylate (PMMA)-augmented screws. This study aimed to assess the short-term outcomes of stage II and III Lenke-Silva degenerative scoliosis in osteoporotic patients managed with augmented pedicle screw fixation. Methods: This prospective case series was conducted at our University Hospitals and included 46 patients presenting with refractory back pain and lower limb claudication unresponsive to medical management or physical therapy for a minimum duration of 6 months. All patients underwent posterior spinal decompression combined with short-segment fixation utilizing pedicle screws augmented with PMMA cement. Results: Visual analog scale (VAS) scores for leg pain demonstrated marked improvement, declining from a pre-operative mean of 7.18–1.51 postoperatively. Similarly, back pain VAS scores decreased from 8.17 before surgery to 1.98 following the intervention. The Oswestry disability index (ODI) demonstrated a statistically significant reduction, with scores decreasing from a baseline mean of 68–19.16 at 24 months postoperatively. The Cobb angle also showed substantial correction, decreasing from a pre-operative mean of 16.32 to lower post-operative values, reaching a final mean of 4.59. Conclusion: Short-segment fusion and decompression utilizing PMMA-augmented screws demonstrated excellent clinical outcomes in the management of degenerative scoliosis in osteoporotic patients, as evidenced by significant improvements in VAS scores for both back and leg pain and ODI scores.