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Degenerative symptomatic lumbar scoliosis
1Department of Orthopaedic Surgery, University of Washington.
Spine
|May 1, 1993
Summary
Adult scoliosis in patients over 50 can progress, especially in women. Key factors like curve severity and vertebral rotation predict worsening spinal deformity and associated pain.
Area of Science:
- Orthopedics
- Spinal Surgery
- Geriatric Medicine
Background:
- Adult scoliosis with progressive deformity can occur later in life.
- This study focuses on patients over 50 with recent onset scoliosis and back pain.
Purpose of the Study:
- To investigate the characteristics and progression of late-onset scoliosis in patients over 50.
- To identify factors predicting curve progression in this demographic.
Main Methods:
- Retrospective study of 200 patients >50 years old with new-onset scoliosis.
- Myelography performed on 45 patients with severe pain and neurologic deficits.
- Analysis of curve parameters, degenerative changes, and progression over 5 years.
Main Results:
- Seventy-one percent of patients were women; curves were typically thoracolumbar (T12-L5) with apex at L2/L3, not exceeding 60 degrees.
- Degenerative facet joint and disc disease, and loss of lumbar lordosis were consistently present.
- Seventy-three percent of patients showed an average progression of 3 degrees/year; Grade 3 apical rotation, Cobb angle ≥30°, lateral translation ≥6mm, and L5 prominence predicted progression.
Conclusions:
- Late-onset scoliosis in older adults is often associated with degenerative changes and can progress significantly.
- Specific radiographic parameters, including curve severity and vertebral rotation, are crucial for predicting progression and guiding management.