Radiographic alterations before and after adult scoliosis surgery: correlation between spinal balance and healthy living status

doi:10.3969/j.issn.2095-4344.2015.04.022

Abstract

Abstract:

BACKGROUND: Radiographic parameters have been incorporated with healthy living status in adult scoliosis patients to guide surgery and predict treatment outcome. However, few studies presented how these radiographic parameters influence treatment outcome in adult scoliosis.

OBJECTIVE: To evaluate the correlation between changes in radiographic parameters and healthy living status in adult scoliosis patients before and after surgery.

METHODS: A total of 68 patients with adult scoliosis, who were treated between July 2008 and July 2010, were retrospectively analyzed. There were 18 males and 50 females, at the age of 20 to 88 years old, averagely 58.5 years. Before surgery and during final follow-up, all patients were photographed at posteroanterior and lateral positions using X-ray. Complete Oswestry Disability Index data were collected. Measurements included gravity line, C₇ plumb line, Cobb angle, lumbar lordosis, slippage distance on coronal side, pelvic angle of incidence, sacral inclination angle and pelvic tilt angle. Correlation of radiological parameters and Oswestry Disability Index values was analyzed using Pearson’s correlation analysis.

RESULTS AND CONCLUSION: Follow-up lasted 6 to 14 months. Significant differences in Oswestry Disability Index score were visible between preoperation (50.6±16.8) and postoperation (41.1±19.6) (P ≤ 0.001). Mean Cobb angle was reduced from 26° preoperatively to 10.7° postoperatively. Lateral olisthesis was reduced from 4.9 mm to almost zero in most patients. On the sagittal plane, C₇plumb line was significantly correlated to Oswestry Disability Index score both preoperatively and postoperatively. On the coronal plane, preoperative Cobb angle and postoperative lumbar lordosis were correlated to Oswestry Disability Index. Pelvic tilt angle change was equal to sacral inclination angle. No changes in pelvic incidence angle were found after the surgery. These data indicated spinal balance was correlated with healthy living status. Gravity line was not better than C₇ plumb line. The improvement of the radiographic parameters did not predict the relief of symptoms. Lost sacral slope and retroverted pelvis were commonly seen in adult scoliosis. Surgical treatment could not significantly change sacral slope, retroverted pelvis, lumbar lordosis and sagittal balance.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: Scoliosis, Pelvis, Radiology, Quality of Life

CLC Number:

R318

Zou Hai-bo, Wu Chun-hui, Amir A. Mehbod, Corky Lick, Ensor E. Transfeldt. Radiographic alterations before and after adult scoliosis surgery: correlation between spinal balance and healthy living status [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(4): 618-622.

Figures/Tables 3

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