Untreated Scoliosis in the Adult

Fowles, John V.; Drummond, Denis S.; L'Ecuyer, S; L, Roy; Kassab, M T

doi:10.1097/00003086-197807000-00033

Cited by 54 publications

(53 citation statements)

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“…Psychological well-being has previously been shown to be influenced by the scoliosis and the appearance of the curve itself [17,21]. The treatment per se may also impact on the quality of life and psychological well-being in a negative way [19,33,35,37].…”

Section: Discussionmentioning

confidence: 99%

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Health-related quality of life in patients with adolescent idiopathic scoliosis: a matched follow-up at least 20 years after treatment with brace or surgery

et al. 2001

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No results on long-term outcome in terms of health-related quality of life (HRQL) have previously been presented for patients treated for adolescent idiopathic scoliosis. A consecutive series of patients with adolescent idiopathic scoliosis, treated between 1968 and 1977 before the age of 21, either with distraction and fusion using Harrington rods [surgical treatment group (ST), n=156; 145 females and 11 males] or with a brace [brace treatment group (BT), n=127; 122 females and 5 males] were followed at least 20 years after completion of the treatment. Ninety-four percent of ST and 91% of BT patients filled in a questionnaire comprising the SF-36, Psychological General Well-Being Index (PGWB), Oswestry Disability Back Pain Questionnaire, parts of SRS/MODEM'S questionnaire and study-specific questions concerning the treatment, as a part of an unbiased personal follow-up examination including radiography and clinical examination. An age-and sex-matched control group of 100 persons was randomly selected and subjected to the same examinations. The results showed no differences in terms of sociodemographic data between the groups. Both ST and BT patients had a slightly, but significantly, reduced physical function using the SF-36 subscales, SF-36/Physical Component Summary (PCS) score as well as the Oswestry Disability Back Pain Questionnaire compared to the controls. Neither the mental subscales and the Mental Component Summary (MCS) score of SF-36 nor the PGWB index showed any significant difference between the groups. Forty-nine percent of ST, 34% of BT and 15% of controls admitted limitation of social activities due to their back [P<0.001 ST vs controls, P=0.0010 BT vs controls, and n.s. (P=0.024) ST vs BT], mostly due to difficulties with physical participation in activities or selfconsciousness about appearance. Pain was a minor reason for limitation. No correlation was found between the outcome scores and curve size after treatment, curve type, total treatment time or age at completed treatment. Patients treated for adolescent idiopathic scoliosis were found to have approximately the same HRQL as the general population. A minority of the patients (4%) had a severely decreased psychological well-being, and a few (1.5%) were severely physically disabled due to the back.

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Section: Discussionmentioning

confidence: 99%

“…New questionnaires have been developed [2,7,29] and are currently being evaluated [29]. A number of previous studies have discussed quality of life (QL) in general terms [12,17,21,34]. So far, only a few studies using modern, validated questionnaires have been published.…”

mentioning

confidence: 99%

Health-related quality of life in patients with adolescent idiopathic scoliosis: a matched follow-up at least 20 years after treatment with brace or surgery

et al. 2001

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“…Severe AIS may result in early degenerative joint disease, (7) cardiopulmonary compromise, (8) negative body image, (9) and psychosocial disturbances. (10) Understanding the etiology of scoliosis may provide opportunities for early intervention, perhaps enabling limitation of curve size. One particular area of interest is the association between weight and scoliosis, with an increasing body of research suggesting that lower body weight is associated with scoliosis.…”

Section: Introductionmentioning

confidence: 99%

Association Between Components of Body Composition and Scoliosis: A Prospective Cohort Study Reporting Differences Identifiable Before the Onset of Scoliosis

Clark

Taylor

Harding

et al. 2014

Journal of Bone and Mineral Research

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There is an increasing body of research suggesting that low body weight is associated with scoliosis, but this is based on case-control studies, which are prone to bias. No studies have investigated the components of body weight: fat and lean mass. We have therefore carried out the first population-based prospective study of the association between fat and lean mass at age 10 years assessed by dual-energy X-ray absorptiometry (DXA), with presence of scoliosis at age 15 years using the Avon Longitudinal Study of Parents and Children (ALSPAC). All children with scoliosis at age 10 years were excluded. Of 5299 children at age 15 years, 312 (5.9%) had scoliosis. Our results show a negative association between body mass index (BMI)/body weight at age 10 years and scoliosis at age 15 years, with a 20% reduced risk of scoliosis per SD increase in BMI (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.70-0.92; p ¼ 0.001). This association with BMI/body weight reflects associations with both fat mass and lean mass. After adjustment for age, gender, leg length, and fat mass per SD increase in lean mass, there was a 20% reduced risk of scoliosis (OR, 0.80; 95% CI, 0.65-0.97) and per SD increase in fat mass there was a 13% reduced risk of scoliosis (OR, 0.87; 95% CI, 0.74-1.03). In terms of adipocyte function, an inverse association was seen between leptin at age 10 years and scoliosis (OR for scoliosis per SD increase in leptin of 0.78; 95% CI, 0.63-0.99), and a positive association between adiponectin at age 10 years and scoliosis (OR for scoliosis per SD increase in adiponectin of 1.44; 95% CI, 0.99-2.10). This is the first study to address the association between the individual components of body weight and scoliosis in a prospective cohort study, and shows altered body composition that is present before the onset of clinically detected scoliosis.

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“…Еще 25-30 лет назад информации о сколиозе взрослых и/или дегенера-тивном сколиозе было мало [11,13,25], а большинство работ в литературе посвящено сколиозу детей и подрост-ков. Только с внедрением спинально-го стабилизирующего сегментарного инструментария [4] и минимально-инвазивных технологий значительно расширились взгляды на возможно-сти хирургической помощи пожилым пациентам, которые, как правило, и страдают этой патологией [15,19].…”

Section: Discussionunclassified

Minimally Invasive Surgical Treatment for Adult Degenerative Lumbar Scoliosis

Krutko¹,

Дурни²,

Васильев³

et al. 2018

Hir. pozvonoč.

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Сколиоз взрослых диагностирует-ся у пациентов со зрелым скелетом при деформации во фронтальной плоскости более 10° по Cobb [2,23] и встречается в популяции, по данным различных источников, в 1,4-68,0 % [21,22]. Традиционно данная патоло-гия лечилась консервативно, посколь-ку возраст пациентов, наличие сопут-ствующей соматической патологии, предполагаемая кровопотеря и трав-матичность оперативного вмешатель-ства по коррекции и стабилизации деформации накладывали значитель-ные ограничения, таких пациентов включали в группу высокого риска.При этом вызывал сомнение тот факт, что сниженная минеральная плот-ность костной ткани у пациентов этой возрастной группы может выдер-жать напряжение системы после про-ведения корригирующего маневра. Большое число осложнений у паци-ентов старше 65 лет [12] не добавля-Minimally invasive surgical treatment for adult degenerative lumbar scoliosis A.V. Krutko, P. Durny, A.I. Vasilyev, A.V. Bulatov Objective. To assess the efficacy of decompression, correction, and stabilization of the lumbar spine deformity using minimally invasive techniques in patients with degenerative lumbar scoliosis. Material and Methods. A retrospective controlled two-center study included 62 patients who underwent surgery for clinical manifestations of degenerative scoliosis of the lumbar spinal canal. Results. Average Oswestry index before surgery was 69.69 %, after surgery it decreased to 33.00 % and ranged between 14 and 50 %. Average magnitude of the lumbar lordosis after surgery was 39.2°; average rate of deformity correction -56.53 %; average magnitude of deformity reduced to 13.46° ± 6.08°. Two-fold reduction of the apical vertebra rotation was observed. Conclusion. The use of the principles of minimally invasive surgery allows to expand the indications for surgical treatment of degenerative spinal deformities and the scope of intervention, and to reduce intraoperative blood loss. Key Words: degenerative scoliosis, minimally invasive surgery.Hir. Pozvonoc. 2014; (3):49-56.Цель исследования. Оценка эффективности декомпрес-сии, коррекции и стабилизации деформации пояснично-го отдела позвоночника у пациентов с дегенеративным поясничным сколиозом с применением минимально-ин-вазивных технологий. Материал и методы. В ретроспективное контролируе-мое двуцентровое исследование включены 62 пациента, прооперированные по поводу клинических проявлений дегенеративного сколиоза поясничного отдела позво-ночного канала. Результаты. Перед операцией индекс Освестри в среднем составлял 69,69 %, после операции снизился до 33,00 % и варьировал от 14 до 50 %. Средняя величи-на поясничного лордоза у больных после операции со-ставила 39,2°; средняя величина коррекции деформации -56,53 %; средняя величина деформации уменьшилась до 13,46° ± 6,08°. Отмечено уменьшение ротации вершин-ного позвонка в два раза. Заключение. Использование принципов минимально-инвазивной хирургии позволяет расширить показания к оперативному лечению дегенеративных деформаций позвоночника, объем самого вмешательства, уменьшить интраоперационную кровопо...

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Untreated Scoliosis in the Adult

Cited by 54 publications

References 0 publications

Health-related quality of life in patients with adolescent idiopathic scoliosis: a matched follow-up at least 20 years after treatment with brace or surgery

Health-related quality of life in patients with adolescent idiopathic scoliosis: a matched follow-up at least 20 years after treatment with brace or surgery

Association Between Components of Body Composition and Scoliosis: A Prospective Cohort Study Reporting Differences Identifiable Before the Onset of Scoliosis

Minimally Invasive Surgical Treatment for Adult Degenerative Lumbar Scoliosis

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