Relationship Between Radiographic Parameters and Clinical Manifestations in Degenerative Lumbar Scoliosis

INTRODUCTION: Purpose of this study was to investigate radiographic and clinical manifestations of degenerative lumbar scoliosis.

METHODS: 74 patients with symptomatic degenerative lumbar scoliosis were analyzed. Spinal balance, lumbar curvature, segmental instability, and sacropelvic parameters were measured in sagittal and coronal plane. Spinal canal stenosis was evaluated by myelogram. Clinical manifestations were assessed by using Japanese orthopaedic association back score. Relationship between radiographic parameters and clinical manifestations was analyzed.

RESULTS: Sagittal spinal imbalance, decrease of lumbar lordosis, and posterior pelvic rotation were significant risk factors for poor clinical manifestations. Symptomatic spinal stenosis was most frequently occurred at L4/5 (65%). There were 33% of patients with monoradiculopathy. Nerve root entrapment occurred at concave side in 27%, at convex side in18%of patients.

CONCLUSION: Sagittal spinopelvic alignment was revealed to be the important factor regulating clinical manifestations in patients with degenerative lumbar scoliosis. Radiographic parameters in coronal plane were associated with neurological compromise.