Radiological parameters associated with the evolution of degenerative scoliosis

The risk factors related to the evolution of the degenerative adult scoliosis are investigated. A review was conducted of the the radiographs of 162 women (mean age 65 years) with degenerative scoliosis who were examined at the Research Center for Diseases of the Musculoskeletal System "Th. Garofalidis" Orthopaedic Department, at the Medical School of Athens University, during the period of 1985 through 1994. Only patients with degenerative lumbar curves greater than 10 degrees and only patients with no previous history of scoliosis were included in the study. The mean follow-up was 8 years (range 5-30 years) and for 30 patients the follow-up period was more than 10 years. The research demonstrated that the degenerative changes of the spine may relate to appearance and evolution of scoliotic curves in adults. Additionally, it was found that the risk factors that are associated with the evolution of the degenerative adult scoliosis are: curves over 30 degrees; curves having Grade II and III rotation; curves that are imbalanced and have a secondary compensatory curve that is sharp and angular at the L4-S1 level; curves in which the apex is at the L2-L3 and L3-L4 area; an intercrest line through the L5 vertebra; and vertebral translation equivalent to or more than 6 mm.