Epidemiology and associated radiographic spinopelvic parameters of symptomatic degenerative lumbar scoliosis: are radiographic spinopelvic parameters associated with the presence of symptoms or decreased quality of life in degenerative lumbar scoliosis?

Abstract Background Adult spinal deformities (ASD) represent a growing clinical condition related to chronic pain, disability and reduction in quality of life (QoL). A strong correlation among spinal alignment, spinopelvic parameters and QoL after spinal fusion surgery in ASD patients was thoroughly investigated over the last decade, However, only few studies focused on the relationship between lumbo-pelvic-femoral parameters - such as Femoral Obliquity Angle (FOA), T1 Pelvic Angle (TPA) and QoL. Methods Radiological and clinical data from 43 patients surgically treated with thoracolumbar posterior spinal fusion for ASD between 2015 and 2018 were retrospectively analyzed. The primary outcomes were the correlation between preoperative spino-pelvic-femoral parameters and postoperative clinical, functional outcomes and QoL. Secondary outcomes were: changes in sagittal radiographic parameters spino-pelvic-femoral, clinical and functional outcomes and the rate of complications after surgery. Results Using Spearman’s rank correlation coefficients, spinopelvic femoral parameters (FOA, TPA, pre and post-operative) are directly statistically correlated to the quality of life (ODI, SRS-22, pre and post-operative; > 0,6 strong correlation, p < 0.05). Stratifying the patients according pre preoperative FOA value (High FOA ≥ 10 and Normal/Low FOA < 10), those belonging to the first group showed worse clinical (VAS: 5.2 +/− 1.4 vs 2.9 +/− 0.8) and functional outcomes (ODI: 35.6+/− 6.8 vs 23.2 +/− 6.5) after 2 years of follow-up and a greater number of mechanical complications (57.9% vs 8.3% p < 0.0021). Conclusion Based on our results, preoperative FOA and TPA could be important prognostic parameters for predicting disability and quality of life after spinal surgery in ASD patients and early indicators of possible spinal sagittal malalignment. FOA and TPA, like other and better known spinopelvic parameters, should always be considered when planning corrective surgery in ASD patients.

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The impact of lumbar scoliosis on pain, function and health-related quality of life in postmenopausal women. Urrutia J, Espinosa J, Diaz-Ledezma C, Cabello C. Eur Spine J 2011 May 3. [Epub ahead of print]

The Spine Journal ◽

10.1016/j.spinee.2011.07.014 ◽

2011 ◽

Vol 11 (7) ◽

pp. 679

Keyword(s):

Quality Of Life ◽

Postmenopausal Women ◽

Health Related Quality ◽

Lumbar Scoliosis ◽

Related Quality ◽

Health Related ◽

The Impact

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EVALUATION OF CERVICAL ALIGNMENT AND ITS RELATIONSHIP WITH THORACIC KYPHOSIS AND SPINOPELVIC PARAMETERS AFTER SCOLIOSIS CORRECTION SURGERY

Coluna/Columna ◽

10.1590/s1808-185120171604179252 ◽

2017 ◽

Vol 16 (4) ◽

pp. 265-269 ◽

Cited By ~ 2

Author(s):

Murilo Tavares Daher ◽

José Humberto Pereira Jr ◽

Vinício Nunes Nascimento ◽

Nilo Carrijo Melo ◽

Luiz Carlos Milazzo Netto ◽

...

Keyword(s):

Quality Of Life ◽

Idiopathic Scoliosis ◽

Thoracic Kyphosis ◽

High Density ◽

Spinopelvic Parameters ◽

Cervical Alignment ◽

Radiographic Parameters ◽

Quality Of Life Questionnaires

ABSTRACT Objectives: To evaluate the cervical alignment after the correction of idiopathic scoliosis using high screw density and direct vertebral derotation (DVD) and to correlate it with thoracic kyphosis, spinopelvic parameters, and quality of life. Methods: Retrospective cohort study. We assessed the medical records and radiographs of patients submitted to idiopathic scoliosis surgery using high density of pedicular screws (80%) and DVD with at least 6 months of follow-up. All the radiographic parameters were evaluated in the preoperative period and in the last postoperative visit. Results: A total of 43 patients were evaluated, of which 35 (81%) were female. The mean age was 15 years (11 to 30 years) with a mean follow-up of one year and four months. Regarding Lenke’s classification, 14 were of group 1, five of group 2, 10 of group 3, eight of group 4, four of group 5 and two of group 6. Only four patients had sagittal modifier (+) and two sagittal modifier (-).There was no significant difference between pre and postoperative thoracic kyphosis. When we evaluated the groups with +, N and - thoracic modifiers, we observed hypokyphotic and normokyphotic patients (- and N) had an increase in kyphosis, whereas hyperkyphotic patients (+)had a decrease. There was no statistical difference in relation to the radiographic parameters of the cervical spine in the pre and postoperative periods. There was a significant improvement in most of the parameters of the quality of life questionnaires, but no correlation with the cervical radiographic parameters. Conclusion: Correction of idiopathic scoliosis using a high density of pedicular screws and a direct vertebral derotation technique failed to improve thoracic kyphosis or change the cervical sagittal alignment, despite promoting a significant improvement in the parameters of quality of life questionnaires.

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