Abnormalities of the lumbar spine in the coronal plane on plain abdominal radiographs

Abstract

The main objective of this study is to determine the prevalence of coronal abnormalities of the lumbar spine in a large population of patients with respect to their age and sex. Lumbar degenerative disease is associated with degenerative scoliosis. Degenerative scoliosis and lateral listhesis are important features to identify before decompressive surgery as deformity may not be seen on magnetic resonance imaging scans. Scoliosis and lateral listhesis may be important in the development of symptoms especially in an ageing population. All abdominal and plain kidney-ureter-bladder radiographs performed over a 10-month period were reviewed. 2,765 radiographs were assessed for scoliosis (Cobb angle greater then 10°), lateral listhesis and evidence of osteoarthritis. The prevalence of scoliosis, lateral listhesis and osteoarthritis of the lumbar spine increased with age. Scoliosis and lateral listhesis were significantly more prevalent in women. Deformity starts to occur after the age of 50 and steadily increases with age. By the ninth decade nearly a quarter of patients have evidence of scoliosis and lateral listhesis. As the adult lumbar spine ages, the prevalence of lateral listhesis and degenerative scoliosis increases. It is important to appreciate these coronal abnormalities in patients undergoing decompressive surgery for spinal stenosis. This increase in deformity may have a greater impact as the population continues to age.

Outcomes in Adult Scoliosis Patients Who Undergo Spinal Fusion Stopping at L5 Compared with Extension to the Sacrum

“…Adult scoliosis (Cobb angle > 10 degrees) is a common disorder with reported prevalence up to 60 to 68% 1 2 and appears to be more prevalent and more severe in women. 1 3 4 5 The relationship between the magnitude of deformity and the severity and existence of symptoms has not been clearly established. 1 5 However, adults with scoliosis report significantly higher pain, functional impairment, and effect on quality of life than those without scoliosis.…”

Conservative Treatment of Degenerative Lumbar Scoliosis

“…The study showed that lumbar scoliosis is more prevalent in women and increases with age [6]. At the ages of between 60 and 69 years, the prevalence was 6%, whereas at the age of 90 years, the prevalence was over 30% [6]. It has, however, to be noted that the study did not differentiate between adult idiopathic scoliosis and DLS and that the radiographs employed were supine films, which might underestimate the Cobb angle and thus the prevalence of lumbar scoliosis.…”

“…The marked variation in prevalence reported is possibly a result of the differences in inclusion criteria of the different studies. Kilshaw et al [6] evaluated the prevalence of lumbar scoliosis using abdominal and kidney-ureterbladder radiographs on patients over the age of 20 years [6]. The study showed that lumbar scoliosis is more prevalent in women and increases with age [6].…”

“…Kilshaw et al [6] evaluated the prevalence of lumbar scoliosis using abdominal and kidney-ureterbladder radiographs on patients over the age of 20 years [6]. The study showed that lumbar scoliosis is more prevalent in women and increases with age [6]. At the ages of between 60 and 69 years, the prevalence was 6%, whereas at the age of 90 years, the prevalence was over 30% [6].…”

The Michel Benoist and Robert Mulholland Yearly European Spine Journal Review: a survey of the “medical” articles in the European Spine Journal, 2011

“…There is an interesting article in the March issue by Kilshaw et al [21] dealing with abnormalities of the lumbar spine seen in the coronal plane on plain radiographs. The objective of this study was to evaluate the prevalence of abnormalities on plain abdominal radiographs with respect to age and sex.…”