How Is Degenerative Lumbar Scoliosis Associated with Spinopelvic and Lower-Extremity Alignments in the Elderly

Wang, Jili; Ushirozako, Hiroki; Yamato, Yu; Ide, Koichiro; Hasegawa, Tomohiko; Yoshida, Go; Banno, Tomohiro; Oe, Shin; Arima, Hideyuki; Mihara, Yuki; Watanabe, Yasuhide; Nakai, Keiichi; Kurosu, Kenta; Hoshino, Hironobu; Matsuyama, Yukihiro

doi:10.31616/asj.2022.0103

Cited by 4 publications

(1 citation statement)

References 28 publications

(46 reference statements)

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“…Degenerative scoliosis is a three-dimensional deformity of the spine caused by degenerative changes in the lumbar intervertebral disc and articular processes [1,2] . Unlike idiopathic scoliosis, patients with this condition typically experience persistent low back and leg pain, as well as intermittent claudication, prompting them to seek medical attention [3][4][5] . Due to the growing emphasis on quality of life, an increasing number of patients are opting for surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

A Study of Risk Factors Associated with Clinical Outcomes Following Surgery for Degenerative Lumbar Scoliosis

Zheng,

Wang,

Wang

et al. 2024

Preprint

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Objective: To investigate the risk factors for the prognosis of degenerative lumbar scoliosis after surgery. Methods: A retrospective analysis was performed to compare the preoperative and postoperative clinical data to assess the prognosis, and to evaluate the patients after surgery by combining the Oswestry Disability Index (ODI) Quality of life. Based on different surgical outcomes, we divide patients into a better prognosis group and a poor prognosis group. Comprehensive risk factors were collected which may related to clinical outcomes included three aspects: patient general status, surgery-related data and imaging parameters. All risk factors were first analyzed through single risk factor analysis, and then multiple logistic regression analysis and Receiver Operating Characteristic (ROC) curves were used to analyze factors related to prognosis after orthopedic surgery. Results: One hundred and thirty-four patients with degenerative lumbar scoliosis who undergone posterior surgery were included in this study. There were 36 men and 98 women with a mean age of 59.4±7.8 years. After identifying potential risk factors that may affect postoperative efficacy through univariate logistic regression, multivariate logistic regression analysis showed that the subcutaneous fat tissue thickness (SFTT) (OR=0.410, P=0.043) , MRI-based vertebral bone quality (VBQ) (OR=0.076, P=0.037), Quantitative Computed Tomography (QCT) (OR=1.401, P=0.008) , degree of kyphosis correction (OR=1.399, P=0.021), sagittal balance correction distance (OR=2.634, P=0.011) were independent predictors of poor prognosis. ROC curve analysis showed that correction degree of kyphosis >20.23°(AUC=0.881, P=0.001), sagittal balance correction distance >2.92CM (AUC=0.834, P=0.001) , QCT >104.6mg/cm3(AUC=0.958, P=0.001)，VBQ <2.88(AUC=0.669, P=0.001)，SFTT <13.5 mm (AUC=0.740, P=0.001) were indicating good clinical efficacy. Conclusions: In patients with degenerative lumbar scoliosis, posterior decompression and fixed fusion surgery can significantly relieve pain and improve quality of life. Among the many factors that may affect prognosis, the correction of kyphosis and sagittal balance is particularly crucial for the postoperative quality of life. Due to the impact of SFTT, VBQ, and QCT on clinical prognosis, patients are encouraged to undergo anti-osteoporosis treatment and early lumbar and dorsal muscle exercise.

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Section: Introductionmentioning

confidence: 99%

A Study of Risk Factors Associated with Clinical Outcomes Following Surgery for Degenerative Lumbar Scoliosis

Zheng,

Wang,

Wang

et al. 2024

Preprint

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Does the Amount of Correction of Sagittal Deformity Really Promote Proximal Junctional Kyphosis? Multivariate Analyses According to Uppermost Instrumented Vertebra Levels

et al. 2023

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Comparison of Surgical Burden, Radiographic and Clinical Outcomes According to the Severity of Baseline Sagittal Imbalance in Adult Spinal Deformity Patients

Park,

Kang

et al. 2024

Neurospine

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Objective: To determine the clinical impact of the baseline sagittal imbalance severity in patients with adult spinal deformity (ASD).Methods: We retrospectively reviewed patients who underwent ≥ 5-level fusion including the pelvis, for ASD with a ≥ 2-year follow-up. Using the Scoliosis Research Society-Schwab classification system, patients were classified into 3 groups according to the severity of the preoperative sagittal imbalance: mild, moderate, and severe. Postoperative clinical and radiographic results were compared among the 3 groups.Results: A total of 259 patients were finally included. There were 42, 62, and 155 patients in the mild, moderate, and severe groups, respectively. The perioperative surgical burden was greatest in the severe group. Postoperatively, this group also showed the largest pelvic incidence minus lumbar lordosis mismatch, suggesting a tendency towards undercorrection. No statistically significant differences were observed in proximal junctional kyphosis, proximal junctional failure, or rod fractures among the groups. Visual analogue scale for back pain and Scoliosis Research Society-22 scores were similar across groups. However, severe group’s last follow-up Oswestry Disability Index (ODI) scores significantly lower than those of the severe group.Conclusion: Patients with severe sagittal imbalance were treated with more invasive surgical methods along with increased the perioperative surgical burden. All patients exhibited significant radiological and clinical improvements after surgery. However, regarding ODI, the severe group demonstrated slightly worse clinical outcomes than the other groups, probably due to relatively higher proportion of undercorrection. Therefore, more rigorous correction is necessary to achieve optimal sagittal alignment specifically in patients with severe baseline sagittal imbalance.

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How Is Degenerative Lumbar Scoliosis Associated with Spinopelvic and Lower-Extremity Alignments in the Elderly

Cited by 4 publications

References 28 publications

A Study of Risk Factors Associated with Clinical Outcomes Following Surgery for Degenerative Lumbar Scoliosis

A Study of Risk Factors Associated with Clinical Outcomes Following Surgery for Degenerative Lumbar Scoliosis

Does the Amount of Correction of Sagittal Deformity Really Promote Proximal Junctional Kyphosis? Multivariate Analyses According to Uppermost Instrumented Vertebra Levels

Comparison of Surgical Burden, Radiographic and Clinical Outcomes According to the Severity of Baseline Sagittal Imbalance in Adult Spinal Deformity Patients

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