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European Spine Journal
Published in: European Spine Journal 6/2014

01-10-2014 | Original Article

Adult scoliosis: age-related deformity and surgery

Authors: Silvana De Giorgi, Giuseppe De Giorgi, Carmela Borracci, Silvio Tafuri, Andrea Piazzolla, Biagio Moretti

Published in: European Spine Journal | Special Issue 6/2014

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Abstract

Purpose

We retrospectively analyzed our results in thoracolumbar and lumbar adolescent idiopathic scoliosis treated during adulthood.

Methods

Fifty-two thoracolumbar and 30 lumbar idiopathic scoliosis surgically treated were reviewed. Mean follow-up was 9.5 ± 6.6 years. All the subjects were analyzed by visual analog scale, Oswestry Disability Index (ODI), and SF-36 scores before and after surgery and at follow-up. The scoliotic curve, thoracic kyphosis, lumbar lordosis, pelvic incidence (PI), pelvic tilt (PT), sacral slope, and C7 plumb line were measured. For the statistical analysis, multivariate multiple regression models were formulated, considering as significative a P < 0.05.

Results

A statistically significant clinical and radiological amelioration was noted after surgery and at final follow-up. According to the logistic regression model, ODI was related to lumbar lordosis and spino-pelvic parameters at follow-up. The only determinant of failure was age.

Conclusions

Spino-pelvic recovery is easier in patients aged less than 60 years with PI < 55° and PT < 25°.
Literature
1.
Le Huec JC, Charosky S, Barrey C, Rigal J, Aunoble S (2011) Sagittal imbalance cascade for simple degenerative spine and consequences: algorithm of decision for appropriate treatment. Eur Spine J 20(S5):S699–S703CrossRef
2.
3.
Guillaumat M (1999) Natural history of scoliosis from childhood to old age. Bull Acad. Nati Med 183(4):705–718
4.
Cotrel Y, Dubousset J, Guillaumat M (1988) New universal instrumentation in spinal surgery. Clin Orthop Relat Res 227:10–23PubMed
5.
Stagnara P, De Mauroy JC, Dran G, Gonon G, Costanzo G, Dimnet J, Pasquet A (1982) Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of kyphosis and lordosis. Spine 7(4):335–342PubMedCrossRef
6.
Stagnara P (1982) Scoliosis in adults. Consequences of idiopathic scoliosis in adulthood. Chirurgie 108(4):356–363PubMed
7.
Dubousset J (1994) Three dimensional analysis of the scoliotic deformity. In: Weinstein SL (ed) Pediatric spine: principles and practice. Raven, New York
8.
Legaye J, Duval-Beaupere G, Hecquet J, Marty C (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7(2):99–103PubMedCrossRefPubMedCentral
9.
Roussouly P, Labelle H, Rouissi J, Bodin A (2012) Pre- and post-operative sagittal balance in idiopathic scoliosis: a comparison over the ages of two cohorts of 132 adolescents and 52 adults. Eur Spine J 22:S203–S215. doi:10.​1007/​s00586-012-2571-x PubMedCrossRef
10.
Roussouly P, Berthonnaud E, Dimnet J (2003) Geometrical and mechanical analysis of lumbar lordosis in an asymptomatic population: proposed classification. Rev Chir Reparatr App Mot 89(7):632–639
11.
Roussouly P, Gollogly S, Noseda O, Berthonnaud E, Dimnet J (2006) The vertical projection of the sum of the ground reactive forces of a standing patient is not the same as the C7 plumbline: a radiographic study of the sagittal alignment of 153 asymptomatic volunteers. Spine 31(11):E320–E325PubMedCrossRef
12.
Roussouly P, Gollogly S, Berthonnaud E, Dimnet J (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine 30:346–353PubMedCrossRef
13.
14.
Farcy JP, Schwab FJ (1997) Management of flatback and related kyphotic decompensation syndromes. Spine 22:2452–2457PubMedCrossRef
15.
Le Huec JC, Aunoble S, Leijssen P, Pellet N (2011) Pelvic parameters: origin and significance. Eur Spine J 20(S5):S564–S571CrossRef
16.
Mac-Thiong JM, Roussouly P, Berthonnaud E, Guigui P (2010) Sagittal parameters of global spinal balance: normative values from a prospective cohort of seven hundred nine Caucasian asymptomatic adults. Spine 35(22):E1193–E1198PubMedCrossRef
17.
De Wald CJ, Stanley T (2006) Instrumentation-related complications of multilevel fusions for adult spinal deformity patients over age 65. Spine 31:S144–S151CrossRef
18.
Berjano P, Lamartina C (2013) Far lateral approaches (XLIF) in adult scoliosis. Eur Spine J 22:S242–S253PubMedCrossRef
19.
Lafage V, Schwab F, Vira S, Patel A, Ungar B, Frcy JP (2011) Spino-pelvic parameters after surgery can be predicted: a preliminary formula and validation of standing alignment. Spine 36(13):1037–1045PubMedCrossRef
20.
Murata Y, Takahashi K, Yamagata M, Hanaoka E, Moriya H (2003) The knee-spine syndrome. Association between lumbar lordosis and extension of the knee. J Bone Joint Surg Br 85:95–99PubMedCrossRef
21.
Mangione P, Senegas J (1997) L’équilibre rachidien dans le plan sagittal. Rev Chir Orthop 83:22–32PubMed
22.
Rose PS, Bridwell KH, Lenke LG, Cronen GA, Mulconrey DS, Buchowski JM, Kim YJ (2009) Role of pelvic incidence, thoracic kyphosis, and patient factors on sagittal plane correction following pedicle subtraction osteotomy. Spine 34(8):785–791PubMedCrossRef
23.
Van Royen BJ, De Gast A, Smit TH (2000) Deformity planning for sagittal plane corrective osteotomies of the spine in ankylosing spondylitis. Eur Spine J 9(6):492–498PubMedCrossRefPubMedCentral
24.
Berthonnaud E, Dimner J, Roussouly P, Labelle H (2004) Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spine Disord 18(1):40–47CrossRef
25.
Danisa OA, Turner D, Richardson WJ (2000) Surgical correction of lumbar kyphotic deformity: posterior reduction “eggshell” osteotomy. J Neurosurg 92(S1):50–56PubMed
Metadata
Title
Adult scoliosis: age-related deformity and surgery
Authors
Silvana De Giorgi
Giuseppe De Giorgi
Carmela Borracci
Silvio Tafuri
Andrea Piazzolla
Biagio Moretti
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 6/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3549-7

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