Zhu Feng, Bao Hongda, Yan Peng, Liu Shunan, Bao Mike, Zhu Zezhang, Liu Zhen, Qiu Yong
Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
BMC Musculoskelet Disord. 2017 Mar 29;18(1):128. doi: 10.1186/s12891-017-1471-y.
The factors associated with lateral curve flexibility in degenerative scoliosis have not been well documented. Disc degeneration could result in significant change in stiffness and range of motion in lateral bending films. The osteophytes could be commonly observed in degenerative spine but the relationship between osteophyte formation and curve flexibility remains controversial. The aim of the current study is to clarify if the disc degeneration and osteophyte formation were both associated with curve flexibility of degenerative scoliosis.
A total of 85 patients were retrospectively analyzed. The inclusion criteria were as follow: age greater than 45 years, diagnosed as degenerative scoliosis and coronal Cobb angle greater than 20°. Curve flexibility was calculated based on Cobb angle, and range of motion (ROM) was based on disc angle evaluation. Regional disc degeneration score (RDS) was obtained according to Pfirrmann classification and osteophyte formation score (OFS) was based on Nanthan classification. Spearman correlation was performed to analyze the relationship between curve flexibility and RDS as well as OFS.
Moderate correlation was found between RDS and curve flexibility with a Spearman coefficient of -0.487 (P = 0.009). Similarly, moderate correlation was observed between curve flexibility and OFS with a Spearman coefficient of -0.429 (P = 0.012). Strong correlation was found between apical ROM and OFS compared to the relationship between curve flexibility and OFS with a Spearman coefficient of -0.627 (P < 0.001).
Both disc degeneration and osteophytes formation correlated with curve rigidity. The pre-operative evaluation of both features may aid in the surgical decision-making in degenerative scoliosis patients.
与退行性脊柱侧凸侧弯灵活性相关的因素尚未得到充分记录。椎间盘退变可导致侧弯X线片上的刚度和活动范围发生显著变化。骨赘在退行性脊柱中较为常见，但骨赘形成与侧弯灵活性之间的关系仍存在争议。本研究的目的是阐明椎间盘退变和骨赘形成是否均与退行性脊柱侧凸的侧弯灵活性相关。
对85例患者进行回顾性分析。纳入标准如下：年龄大于45岁，诊断为退行性脊柱侧凸且冠状面Cobb角大于20°。根据Cobb角计算侧弯灵活性，基于椎间盘角度评估活动范围（ROM）。根据Pfirrmann分级获得区域椎间盘退变评分（RDS），基于Nanthan分级获得骨赘形成评分（OFS）。采用Spearman相关性分析来分析侧弯灵活性与RDS以及OFS之间的关系。
RDS与侧弯灵活性之间存在中度相关性，Spearman系数为-0.487（P = 0.009）。同样，侧弯灵活性与OFS之间也观察到中度相关性，Spearman系数为-0.429（P = 0.012）。与侧弯灵活性和OFS之间的关系相比，顶椎ROM与OFS之间存在强相关性，Spearman系数为-0.627（P < 0.001）。
椎间盘退变和骨赘形成均与侧弯僵硬相关。对这两个特征的术前评估可能有助于退行性脊柱侧凸患者的手术决策。
