Masayuki Ohashi1, Kei Watanabe2, Toru Hirano3, Kazuhiro Hasegawa4, Keiichi Katsumi2,5, Hideki Tashi2, Yohei Shibuya2, Hiroyuki Kawashima2. 1. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, 951-8510, Japan. masayuki-ohashi@ksh.biglobe.ne.jp. 2. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, 951-8510, Japan. 3. Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma City, Japan. 4. Niigata Spine Surgery Center, Niigata City, Japan. 5. Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, Niigata City, Japan.
Abstract
PURPOSE: To evaluate the impact of the flexibility of thoracolumbar or lumbar (TL/L) curves on low back pain (LBP) and disc degeneration in adult patients nonoperatively treated for adolescent idiopathic scoliosis (AIS). METHODS: Forty-seven adult patients (46 women; mean age, 40.5 years) nonoperatively treated for AIS with TL/L curves were included. The patients completed radiological examinations, magnetic resonance imaging, and a questionnaire survey for LBP evaluation. The flexibility of the spinal deformity was evaluated using supine side-bending radiographs. Radiographic measurements were correlated with scores for LBP and disc degeneration. RESULTS: The average magnitude and flexibility of the TL/L curve were 49.0° and 56%, respectively. The magnitudes of the TL/L curve and disc wedging were significantly correlated with LBP (|r|= 0.3-0.4). The flexibility of the TL/L curve and disc wedging, and the lumbar lateral range of motion (ROM) were significantly correlated with LBP and disc degeneration (|r|= 0.3-0.5). After controlling for the magnitudes of the TL/L curve and disc wedging, the flexibility of L4/5 disc wedging and the lumbar lateral ROM remained significantly correlated with the Scoliosis Research Society-22 pain score (partial correlation coefficient [r'] = 0.5 and 0.3), Oswestry Disability Index (- 0.3 and - 0.3), and disc degeneration (- 0.4 and 0.3). CONCLUSION: In AIS patients with TL/L curves, the flexibility of L4/5 disc wedging and the lumbar lateral ROM were significantly correlated with LBP and disc degeneration, independent of the magnitudes of the coronal deformities. Our findings indicate that maintaining or improving lumbar flexibility may be beneficial for preventing or treating LBP.
PURPOSE: To evaluate the impact of the flexibility of thoracolumbar or lumbar (TL/L) curves on low back pain (LBP) and disc degeneration in adult patients nonoperatively treated for adolescent idiopathic scoliosis (AIS). METHODS: Forty-seven adult patients (46 women; mean age, 40.5 years) nonoperatively treated for AIS with TL/L curves were included. The patients completed radiological examinations, magnetic resonance imaging, and a questionnaire survey for LBP evaluation. The flexibility of the spinal deformity was evaluated using supine side-bending radiographs. Radiographic measurements were correlated with scores for LBP and disc degeneration. RESULTS: The average magnitude and flexibility of the TL/L curve were 49.0° and 56%, respectively. The magnitudes of the TL/L curve and disc wedging were significantly correlated with LBP (|r|= 0.3-0.4). The flexibility of the TL/L curve and disc wedging, and the lumbar lateral range of motion (ROM) were significantly correlated with LBP and disc degeneration (|r|= 0.3-0.5). After controlling for the magnitudes of the TL/L curve and disc wedging, the flexibility of L4/5 disc wedging and the lumbar lateral ROM remained significantly correlated with the Scoliosis Research Society-22 pain score (partial correlation coefficient [r'] = 0.5 and 0.3), Oswestry Disability Index (- 0.3 and - 0.3), and disc degeneration (- 0.4 and 0.3). CONCLUSION: In AIS patients with TL/L curves, the flexibility of L4/5 disc wedging and the lumbar lateral ROM were significantly correlated with LBP and disc degeneration, independent of the magnitudes of the coronal deformities. Our findings indicate that maintaining or improving lumbar flexibility may be beneficial for preventing or treating LBP.
Authors: Bassel G Diebo; Neil V Shah; Oheneba Boachie-Adjei; Feng Zhu; Dominique A Rothenfluh; Carl B Paulino; Frank J Schwab; Virginie Lafage Journal: Lancet Date: 2019-07-11 Impact factor: 79.321