Abstract
BackgroundThe factors associated with lateral curve flexibility in degenerative scoliosis have not been well documented. Disc degeneration could result in significant change in stiffness and range of motion in lateral bending films. The osteophytes could be commonly observed in degenerative spine but the relationship between osteophyte formation and curve flexibility remains controversial. The aim of the current study is to clarify if the disc degeneration and osteophyte formation were both associated with curve flexibility of degenerative scoliosis.MethodsA total of 85 patients were retrospectively analyzed. The inclusion criteria were as follow: age greater than 45 years, diagnosed as degenerative scoliosis and coronal Cobb angle greater than 20°. Curve flexibility was calculated based on Cobb angle, and range of motion (ROM) was based on disc angle evaluation. Regional disc degeneration score (RDS) was obtained according to Pfirrmann classification and osteophyte formation score (OFS) was based on Nanthan classification. Spearman correlation was performed to analyze the relationship between curve flexibility and RDS as well as OFS.ResultsModerate correlation was found between RDS and curve flexibility with a Spearman coefficient of −0.487 (P = 0.009). Similarly, moderate correlation was observed between curve flexibility and OFS with a Spearman coefficient of −0.429 (P = 0.012). Strong correlation was found between apical ROM and OFS compared to the relationship between curve flexibility and OFS with a Spearman coefficient of −0.627 (P < 0.001).ConclusionsBoth disc degeneration and osteophytes formation correlated with curve rigidity. The pre-operative evaluation of both features may aid in the surgical decision-making in degenerative scoliosis patients.
Highlights
The factors associated with lateral curve flexibility in degenerative scoliosis have not been well documented
The aim of the current study is to clarify if the disc degeneration and osteophyte formation were both associated with curve flexibility of degenerative scoliosis
Moderate correlation was found between Regional disc degeneration score (RDS) and curve flexibility with a Spearman coefficient of −0.487 (P = 0.009)
Summary
The factors associated with lateral curve flexibility in degenerative scoliosis have not been well documented. Disc degeneration could result in significant change in stiffness and range of motion in lateral bending films. The osteophytes could be commonly observed in degenerative spine but the relationship between osteophyte formation and curve flexibility remains controversial. The aim of the current study is to clarify if the disc degeneration and osteophyte formation were both associated with curve flexibility of degenerative scoliosis. The evaluation of spinal lateral flexibility on bending films is vital for classifying structural curve, determining fusion levels and even predicting correction outcome. Several factors have been proposed to be associated with curve flexibility in idiopathic scoliosis, including age, curve magnitude and location [1]. In degenerative scoliosis, the lateral flexibility helps to determine. Disc is the main load-bearing structure and functional motion
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