PROSPECTIVE CLINICO-RADIOLOGICAL CORRELATION OF ADULT DEGENERATIVE SCOLIOSIS.
Authors: Dr. Yogesh Kumar B, Dr. Vidyadhara S, Dr. Thomas J Kishen, Dr. Arun Kumar
Authors Affiliations: Manipal Spine Care Center, Manipal Hospital, Bangalore, India – 560017
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Type of Study:
Prospective clinico-radiological analysis.
Purpose of study:
Adult degenerative scoliosis is highly under-estimated in most clinical settings in India by virtue of challenges in taking good quality whole-spine radiographs. We prospectively analyzed consecutive adult patients presenting with back pain and detected to have spinal deformity on regular Lumbar spine radiographs. We aimed to evaluate radiographic parameters in de-novo degenerative scoliosis and to correlate them with clinical symptoms and mental health.
Present study included 58 consecutive patients with adult de-novo degenerative scoliosis. All patients completed a clinical questionnaire (VAS, ODI, SF-36 and SRS-30) and underwent standing whole-spine radiographs. Radiographic measurements were done using Syngo Imaging XS-VA70A software. Statistical analysis was performed using SPSS Version 20.
We included 58 patients with mean age of 64 years, and majority of them were females (38). Patients with positive sagittal imbalance showed increased pain (VAS 8.1), disability (ODI 44.25%) and decreased SRS-30 score (2.8) compared to coronal imbalance. Patients with both sagittal and coronal imbalance (37) had severe pain (VAS 8.5) and functional disability (ODI 41% and SF36-PCS 33.8) than those with isolated sagittal or coronal imbalance. Patients with both AP and lateral olisthesis (23) had high ODI (42%) and poor SRS function (3.0) than that of individuals with isolated AP or lateral listhesis.
- Patients with both sagittal and coronal imbalance suffered more symptoms than those with individuals with isolated sagittal or coronal imbalance.
- Positive sagittal balance is the most important predictor of clinical symptoms in adult scoliosis.
- Patients with both AP and lateral olisthesis correlated with severe symptoms, but no correlation exists as to which listhesis (AP/Lateral) causes more pain.
- Cobb angle didn’t have correlation with functional ability of patients.
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International Journal of Conference Proceedings. March 2015;(2015):29