PMID: 29750755May 12, 2018Paper

Predicting Factors at Skeletal Maturity for Curve Progression and Low Back Pain in Adult Patients Treated Non-Operatively for Adolescent Idiopathic Scoliosis with Thoracolumbar/Lumbar Curves: A Mean 25-Year Follow-up

Spine
Masayuki OhashiNaoto Endo

Abstract

A retrospective, long-term follow-up study. We aimed to clarify the predicting factors at skeletal maturity for future curve progression and low back pain (LBP) in adolescent idiopathic scoliosis (AIS) with thoracolumbar/lumbar (TL/L) curve. TL/L curves are likely to progress after skeletal maturity and cause LBP. Of 147 patients treated non-operatively for AIS with TL/L curve, 56 (55 females; average age at the time of survey, 39.5 ± 7.1 years; average follow-up duration after maturity, 24.9 ± 6.9 years) completed questionnaires, including the visual analogue scale (VAS) for LBP and Oswestry disability index (ODI). Forty-nine patients underwent a radiological examination, and 48 underwent lumbar magnetic resonance imaging (MRI). The mean Cobb angle of the TL/L curve increased from 37.3°±7.5° to 47.8°±12.6° (0.41°±0.39° per year). The factors at skeletal maturity that were associated with the annual progression of the TL/L curve included a cranially-located apical vertebra, and great apical vertebral translation and L3 tilt. In addition, the VAS for LBP was positively correlated with L4 tilt, and the ODI was positively correlated with L4 tilt and apical vertebral rotation. Multivariate analyses and receiver operating characteri...Continue Reading

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