Treatment of degenerative scoliosis with short-segment decompression / fusion or long-segment decompression / fusion based on Berjano classification

Abstract Obejective: The purpose of this study is to analyze the clinical and imaging results of the two surgical options of short fusion and long fusion according to Berjano classification. Methods: We reviewed data from 92 patients who underwent spinal surgery at our hospital between January 2016 and January 2020. Patients with Berjano I or II were classified as having short segment fusion (SF group) and patients with Berjano III or IV were classified as having long segment fusion (LF group). The age, sex, main causes of treatment, number of fixed segments, clinical efficacy, radiological parameters, reoperation rate and other general conditions of the two groups were compared and analyzed. Results： The number of fused segments in the LF group was 3.8 ± 0.8. The number of fused segments in SF group was 1.6±0.5. The recovery degree of Cobb angle, lumbar lordosis angle (LL) and sagittal vertical axis (SVA) in LF group was better than that in SF group at the last follow-up, but there was no significant difference in reoperation rate and patient satisfaction between the two groups (P>0.05). LF group had a higher incidence of perioperative complications (P<0.05), and there was no significant difference in the incidence of adjacent segment-related complications between the two groups (P = 0.3600). Conclusion: The classification proposed by Berjano can well address the essential needs of ADS patients between symptoms and lateral bending correction, and patients' treatment satisfaction is high, which is a classification worthy of our consideration.