Clinical Relevance of the SRS-Schwab Classification for Degenerative Lumbar Scoliosis

Ha, Kee-Yong; Jang, Wonhee; Kim, Young-Hoon; Park, Dong-Chul

doi:10.1097/brs.0000000000001229

Cited by 41 publications

(34 citation statements)

References 21 publications

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“…As described by Aebi [7], the clinical characteristics and pathophysiology of DNDLS are different compared with other forms of ASD. This has been supported by studies which found very weak correlation between health outcomes and sagittal plane deformity, when limiting ASD to DNDLS [50,51]. It is, therefore, most likely that a distinction between the subtypes of ASD, such as DNDLS, should be made in determining the clinical course.…”

Section: Insufficient Evidencementioning

confidence: 86%

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

et al. 2016

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Purpose To identify prognostic factors for curve progression in de novo degenerative lumbar scoliosis (DNDLS) by performing a systematic review of the literature. Methods Studies were selected for inclusion following a systematic search in the bibliographic databases PubMed and EMBASE prior to September 2015 and hand searches of the reference lists of retrieved articles. Two authors independently assessed methodological quality. Data were extracted and presented according to a best evidence synthesis. Results The literature search generated a total of 2696 references. After removing duplicates and articles that did not meet inclusion criteria, 12 studies were included. Due to the lack of statistical analyses, pooling of data was not possible. Strong evidence indicates that increasing intervertebral disk degeneration, lateral vertebral translation C6 mm, and an intercrest line through L5 (rather than L4) are associated with DNDLS curve progression. Moderate evidence suggests that apical vertebral rotation Grade II or III is associated with curve progression. For the majority of other prognostic factors, we found limited, conflicting, or inconclusive evidence. Osteoporosis, a coronal Cobb angle \30°, lumbar lordosis, lateral osteophytes difference of C5 mm, and degenerative spondylolisthesis have not been shown to be risk factors. Clinical risk factors for progression were not identified. Conclusions This review shows strong evidence that increased intervertebral disk degeneration, an intercrest line through L5, and apical lateral vertebral translation C6 mm are associated with DNDLS curve progression. Moderate evidence was found for apical vertebral rotation (Grade II/III) as a risk factor for curve progression. These results, however, may not be directly applicable to the individual patient.

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Section: Insufficient Evidencementioning

confidence: 86%

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

et al. 2016

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“…Although previous studies have demonstrated the importance to improve the PI‐LL, the optimal PI‐LL for corrective surgery remains controversial. This was the first study to exclusively investigate the association between postoperative PI‐LL and postoperative clinical outcomes based on three SRS‐Schwab PI‐LL sagittal modifiers (<10°, “0”; 10°–20°, “+”; >20°, ++) in ADS who underwent long posterior instrumentation and fusion.…”

Section: Discussionmentioning

confidence: 99%

Optimal Pelvic Incidence Minus Lumbar Lordosis Mismatch after Long Posterior Instrumentation and Fusion for Adult Degenerative Scoliosis

Zhang¹,

Zi-fang²,

Zhao-han³

et al. 2017

Orthopaedic Surgery

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“…The spinal regions are not independent of one another, and CL as an adaptive spinal segment depends on the alignment of both thoracic and lumbar spine. In previous studies of sagittal spinal parameters, Schwab et al proposed a simple approach of "lumbar lordosis = pelvic incidence ± 9°", which has been verified good correlation with HROQL and applied in most reconstructive surgeries at the thoracic and lumbar spine [5,17,18]. Therefore, for the cervical spine, further prospective study of the relationship between predictive CL and postoperative HRQOL outcomes is needed to find out whether predictive CL predicted only by cervical sagittal parameters actually can be applied to surgical planning.…”

Section: Discussionmentioning

confidence: 99%

Predictive formula of cervical lordosis in asymptomatic young population

Zhu

Zhang

et al. 2020

J Orthop Surg Res

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Background: Not a large number of previous studies have reported the normal sagittal balance of the cervical spine and physiological cervical lordosis (CL) has not been clearly defined yet. Methods: This was a prospective radiological analysis of asymptomatic subjects. The following cervical sagittal parameters were measured: CL, thoracic inlet angle (TIA), T1 slope (T1S), neck tilt (NT), and C2-7 sagittal vertical axis (C2-7 SVA). The Pearson correlation test was calculated, and the stepwise multiple regression analysis was conducted by using the CL (dependent variable) and the other cervical sagittal parameters (independent variables) to determine the best sets of predictors. A paired sample t test was conducted between the predicted and measured values. Results: The mean age of 307 participants was 24.54 + 3.07. The mean CL, TIA, T1S, NT, and C2-C7 SVA was 17.11°± 6.31°, 67.87°± 7.78°, 25.84°± 5.36°, 42.53°± 6.68°, and 14.60 ± 8.20 mm, respectively. The formula was established as follows: CL = 0.762 × T1S − 0.392 × C2-C7 SVA + 0.25 × TIA − 13.795 (R = 0.812, R 2 = 0.660) (stepwise multiple regression) and CL = 0.417 × TIA − 11.193 (R = 0.514, R 2 = 0.264) (simple linear regression). There was no statistical difference between the predicted CL and the measured CL (t = 0.034, P = 0.973). Conclusions: There was a significant correlation between CL and other cervical sagittal parameters, including TIA, T1S, NT, and C2-C7 SVA in asymptomatic Chinese population. The results of this study may serve as a normal reference value for the study of asymptomatic population.

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Clinical Relevance of the SRS-Schwab Classification for Degenerative Lumbar Scoliosis

Abstract: 4.

Cited by 41 publications

References 21 publications

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

Optimal Pelvic Incidence Minus Lumbar Lordosis Mismatch after Long Posterior Instrumentation and Fusion for Adult Degenerative Scoliosis

Predictive formula of cervical lordosis in asymptomatic young population

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