The prevalence of adult de novo scoliosis: A systematic review and meta-analysis

McAviney, Jeb; C, Roberts; Sullivan, Bryony; Alevras, Alexander J.; Graham, Petra L.; Brown, Benjamin T.

doi:10.1007/s00586-020-06453-0

Cited by 36 publications

(32 citation statements)

References 28 publications

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“…In ADS patients, the median apex level was the disc L2-3, the mean coronal Cobb angle was 21° ± 8° and ranged from 10° to 47° (Table 1). Furthermore, all ADS curves had their apex in the lumbar area, in concurrence with earlier observations of de novo ADS, and 56% of these primary lumbar curves were left convex (Table 1) [24]. A higher lumbar apex level correlated significantly with a right convex curve (R = 0.282; p = 0.004).…”

Section: Resultssupporting

confidence: 89%

“…3). Furthermore, all ADS curves had their apex in the lumbar area, which is consistent with data from the literature [24,25,28] (Table 1). And a higher lumbar apex correlated significantly with a right-convex curve, which is in concurrence with observations that scoliotic curve convexity tends to follow the slight pre-existent rotational pattern present in the non-scoliotic spine [34].…”

Section: Discussionsupporting

confidence: 91%

“…The femoral heads were aligned and encircled by the observer to get the exact axis through the femoral heads. After selecting the sacral endplate, the pelvic incidence was measured as the angle between the line from the femoral-heads-axis to the mid-point of the sacral endplate, and the perpendicular line from the mid-point of the sacral endplate deformities, the curvature normally develops in the lumbar spine during a phase in life when the torsional stiffness of the intervertebral disc decreases [18,24,25,[27][28][29]. If mechanical characteristics, dictated by the sagittal pelvic morphology, play a role in the development of scoliosis, we expect a similar phenomenon of a higher PI in ADS as was observed in primary lumbar adolescent idiopathic scoliosis.…”

Section: Discussionmentioning

confidence: 99%

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The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

et al. 2021

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Purpose Pelvic morphology dictates the alignment and biomechanics of the spine. Recent observations in different types of adolescent idiopathic scoliosis indicate that individual pelvic morphology is related to the spinal levels in which scoliosis develops: primary lumbar adolescent scoliosis is associated with a higher pelvic incidence (PI) than thoracic scoliosis and non-scoliotic controls. We hypothesize that adult degenerative scoliosis (ADS) of the lumbar spine follows the same mechanical principles and is associated with a high PI. Methods This study used an existing CT-scan database, 101 ADS patients were sex and age matched to 101 controls. The PI was measured by two observers with multi-planar reconstruction, perpendicular to the hip-axis according to a previously validated technique. Results The PI was 54.1° ± 10.8° in ADS patients and 47.7° ± 10.8° in non-scoliotic controls (p < 0.001). The median ADS curve apex was the disc L2-3 and median curve length was 4 vertebral levels. The mean supine Cobb angle was 21° ± 8° (ranged 10°–47°). There was no significant correlation between PI and the apex level (p = 0.883), the curve length (p = 0.418) or the Cobb angle (p = 0.518). Conclusions ADS normally develops de novo in the lumbar spine of patients with a higher PI than controls, similar to primary lumbar adolescent idiopathic scoliosis. This suggests a shared mechanical basis of both deformities. Pelvic morphology dictates spinal sagittal alignment, which determines the segments of the spine that are prone to develop scoliosis.

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Section: Resultssupporting

confidence: 89%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

et al. 2021

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“…Degenerative adult scoliosis can be defined as a scoliosis in adult patients who have no history of scoliosis during childhood or adolescence (no primary scoliosis) but then develop a coronal plane deformity in response with degenerative changes in the spinal column. Degenerative curves usually tend to be of a lower magnitude than idiopathic ones, in which lumbar curves is more common [ [1] , [2] , [3] ].…”

Section: Introductionmentioning

confidence: 99%

“…McAviney et al reported that degenerative adult scoliosis is a condition that affects approximately 38% of the population, and is more dominant in females with age > 60 years old. They also estimated that by 2050, the world's population will be predominantly older people especially with age of >60 years and this condition will increase the prevalence of degenerative adult scoliosis and further will be a significant burden to health care systems throughout the world [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Functional outcomes following surgical treatment in patient with primary degenerative adult scoliosis

Sakti

Saraswaty

Pratama

et al. 2021

International Journal of Surgery Case Reports

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Introduction Primary adult degenerative scoliosis is one of the adult scoliosis group that presents in adult patient without history of scoliosis during childhood or adolescence. This condition may be asymptomatic, mild low back pain, radiculopathy symptoms, or may be causing severe low back pain and major neurological symptoms including weakness and numbness of the lower extremities which can affect the patient quality of life. Case presentation In this study, we presented seven cases of primary degenerative adult scoliosis that was treated either with decompression alone, decompression with short segment fusion and deformity correction, and decompression with long segment fusion and deformity correction. The parameters measured in this study were lumbar regional angle, Cobb angle, and pelvic parameters. The functional status of the patient was measured using Oswestry Disability Index (ODI). Discussion The main purpose for surgical treatment in primary degenerative adult scoliosis depends on the clinical presentation and also the patient's expectations .From the study, we found that all patient underwent surgery had improvement of functional status that measured with ODI score. The mean of pre operative ODI score was 49.70 (± 13.61 SD) (severe disability) and for post operative was 21.8 (± 13.40 SD) (moderate disability). Surgery decompressed the neural element and stabilize the spine. Conclusion Surgery treatment in patients with degenerative adult scoliosis was shown to have better functional outcomes regardless of the technique used. Further study with bigger sample with corresponding statistical analytic is mandatory.

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Multisegment transforaminal lumbar interbody fusion (TLIF) combined with Ponte osteotomy in degenerative lumbar scoliosis (DLS) surgery: a minimum of five years’ follow-up

Qiu

Chu

Niu

et al. 2022

International Orthopaedics (SICOT)

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Purpose To evaluate the long-term clinical outcomes of degenerative lumbar scoliosis (DLS) with the administration of multisegment transforaminal lumbar interbody fusion (TLIF) combined with Ponte osteotomy long-level fixation fusion, as well as to identify the factors affecting health-related quality of life (HRQOL). Methods This was a retrospective single-centre study involving comprehensive clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) outcomes, and Scoliosis Research Society (SRS-22) questionnaire were recorded to assess HRQOL. A correlation analysis was performed to determine the association between HRQOL and radiographic parameters. Results A total of 41 consecutive patients (15 males and 26 females) met the inclusion criteria with a follow-up of 8.62 ± 1.20 years. Factors associated with HRQOL were significantly improved post-operation. Global sagittal parameters, including the sagittal vertebral axis (SVA) and T1 pelvic angle (TPA), and local parameters, including apical vertebral translation (AVT) and apical vertebral rotation (AVR), were significantly improved at the last follow-up. Significantly strong correlations between each clinical and radiographic parameter were demonstrated. Moreover, a multiple linear regression analysis demonstrated that the differences in AVT and AVR were significantly correlated with the difference in lumbar lordosis (LL), which was significantly correlated with the differences in SVA and TPA. Conclusion The surgical treatment of DLS with multisegment TLIF accompanied by Ponte osteotomy and long-level fixations improved the quality of life of patients with a long-term effect. AVR correction is an important factor for LL restoration that significantly correlates with improvements in the sagittal balance parameters SVA and TPA, which are key factors for guaranteeing good HRQOL.

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The prevalence of adult de novo scoliosis: A systematic review and meta-analysis

Cited by 36 publications

References 28 publications

The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

Functional outcomes following surgical treatment in patient with primary degenerative adult scoliosis

Multisegment transforaminal lumbar interbody fusion (TLIF) combined with Ponte osteotomy in degenerative lumbar scoliosis (DLS) surgery: a minimum of five years’ follow-up

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