{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T04:00:46Z","timestamp":1793764846714,"version":"4.6.1"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Patients with degenerative lumbar scoliosis (DLS) and neurogenic pain may be candidates for decompression alone or short-segment fusion. In this study, minimally invasive surgery (MIS) decompression (MIS-D) and MIS short-segment fusion (MIS-SF) in patients with DLS were compared in a propensity score\u2013matched analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The propensity score was calculated using 13 variables: sex, age, BMI, Charlson Comorbidity Index, smoking status, leg pain, back pain, grade 1 spondylolisthesis, lateral spondylolisthesis, multilevel spondylolisthesis, lumbar Cobb angle, pelvic incidence minus lumbar lordosis, and pelvic tilt in a logistic regression model. One-to-one matching was performed to compare perioperative morbidity and patient-reported outcome measures (PROMs). The minimal clinically important difference (MCID) for patients was calculated based on cutoffs of percentage change from baseline: 42.4% for Oswestry Disability Index (ODI), 25.0% for visual analog scale (VAS) low-back pain, and 55.6% for VAS leg pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 113 patients were included in the propensity score calculation, resulting in 31 matched pairs. Perioperative morbidity was significantly reduced for the MIS-D group, including shorter operative duration (91 vs 204 minutes, p &lt; 0.0001), decreased blood loss (22 vs 116 mL, p = 0.0005), and reduced length of stay (2.6 vs 5.1 days, p = 0.0004). Discharge status (home vs rehabilitation), complications, and reoperation rates were similar. Preoperative PROMs were similar, but after 3 months, improvement was significantly higher for the MIS-SF group in the VAS back pain score (\u22123.4 vs \u22121.2, p = 0.044) and Veterans RAND 12-Item Health Survey (VR-12) Mental Component Summary (MCS) score (+10.3 vs +1.9, p = 0.009), and after 1 year the MIS-SF group continued to have significantly greater improvement in the VAS back pain score (\u22123.9 vs \u22121.2, p = 0.026), ODI score (\u221223.1 vs \u22127.4, p = 0.037), 12-Item Short-Form Health Survey MCS score (+6.5 vs \u22126.5, p = 0.0374), and VR-12 MCS score (+7.6 vs \u22125.1, p = 0.047). MCID did not differ significantly between the matched groups for VAS back pain, VAS leg pain, or ODI scores (p = 0.38, 0.055, and 0.072, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Patients with DLS undergoing surgery had similar rates of significant improvement after both MIS-D and MIS-SF. For matched patients, tradeoffs were seen for reduced perioperative morbidity for MIS-D versus greater magnitudes of improvement in back pain, disability, and mental health for patients 1 year after MIS-SF. However, rates of MCID were similar, and the small sample size among the matched patients may be subject to patient outliers, limiting generalizability of these results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.4.spine221047","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T13:36:48Z","timestamp":1686404208000},"page":"394-403","source":"Crossref","is-referenced-by-count":12,"title":["Comparison of minimally invasive decompression alone versus minimally invasive short-segment fusion in the setting of adult degenerative lumbar scoliosis: a propensity score\u2013matched analysis"],"prefix":"10.3171","volume":"39","author":[{"given":"Murray","family":"Echt","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adewale A.","family":"Bakare","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus R.","family":"Varela","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Platt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Daniel and Jane Och Spine Hospital, NewYork-Presbyterian, Columbia University Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Abdul Sami","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Molenda","sequence":"additional","affiliation":[{"name":"WellSpan Neurosurgery, York Hospital, York, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mena","family":"Kerolus","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Piedmont Healthcare, Atlanta Brain and Spine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G.","family":"Fessler","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"20","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"1763","article-title":"Epidemiology of degenerative lumbar scoliosis: a community-based cohort study","volume":"37","author":"Jimbo S","year":"2012","unstructured":"Jimbo S, Kobayashi T, Aono K, Atsuta Y, Matsuno T. Epidemiology of degenerative lumbar scoliosis: a community-based cohort study. Spine (Phila Pa 1976). 2012;37(20):1763\u20131770."},{"issue":"6","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"542","article-title":"Symptomatic lumbar scoliosis with degenerative changes in the elderly","volume":"4","author":"Epstein JA","year":"1979","unstructured":"Epstein JA, Epstein BS, Jones MD. Symptomatic lumbar scoliosis with degenerative changes in the elderly. Spine (Phila Pa 1976). 1979;4(6):542\u2013547."},{"issue":"6","key":"b3","series-title":"Neurosurgery","first-page":"1181","article-title":"Prevalence, severity, and impact of foraminal and canal stenosis among adults with degenerative scoliosis","volume":"69","author":"Fu KMG","year":"2011","unstructured":"Fu KMG, Rhagavan P, Shaffrey CI, Chernavvsky DR, Smith JS. Prevalence, severity, and impact of foraminal and canal stenosis among adults with degenerative scoliosis. 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