Article

Adult scoliosis is a condition in which the spinal deformity occurs
because of degeneration. Although various studies have agreed on the importance
of restoring the sagittal balance, few have evaluated the relationship between
functional scores and radiological parameters.
The primary objective of this
retrospective study was to demonstrate the correlation between radiographic
parameters and functional outcomes in adult patients with lumbar or thoracolumbar
degenerative scoliosis.
The secondary objective was to assess the long-term
effects of posterolateral fusion for treating this deformity. STUDY OUTLINE: This
single-centre retrospective study included 47 patients over 50years of age who
had degenerative lumbar scoliosis treated with an instrumented posterolateral
fusion; the mean follow-up was 6.4years (range 2 to 20). METHODS: Radiographic
analysis of A/P and lateral full spine standing radiographs was carried out with
the KEOPS software. Three pelvic parameters (pelvic tilt, pelvic incidence,
sacral slope), two spinal parameters (lumbar lordosis and thoracic kyphosis) and
three sagittal balance parameters (C7 sagittal tilt, C7 Barrey's ratio and
spinosacral angle) were calculated. The functional outcomes were evaluated
through three self-assessment questionnaires: Oswestry Disability Index, SRS-30
and SF-36. The correlation between clinical and radiographic parameters was
calculated with Spearman's correlation test. RESULTS: There was a significant
correlation between the SF-36 (PCS) and the following three sagittal parameters:
sacral slope (r=-0.31453; P=0.04), lumbar lordosis (r=-0.30198; P=0.0491) and
spinosacral angle (r=-0.311967; P=0.0366). The mean ODI score was 33.61, which
corresponds to minimal to moderate disability. The mean physical (PCS) and mental
(MCS) component summary scores of the SF-36 were 37.70 and 38.40, respectively.
The mean SRS-30 score was 3.07. CONCLUSION: It is essential that the sagittal
balance be restored when treating degenerative lumbar scoliosis to generate
better functional outcomes and better quality of life. To achieve this
correction, instrumented posterolateral fusion appears to be a very reliable
technique that leads to lasting improvement. LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2016 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS