Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
Spine Deform. 2021 May;9(3):711-720. doi: 10.1007/s43390-020-00252-9. Epub 2020 Nov 27.
To elucidate the influence of spinal deformity in adolescent idiopathic scoliosis (AIS) on lumbar intervertebral disc (IVD) degeneration in adulthood using magnetic resonance imaging (MRI).
A total of 102 patients (8 men, 94 women; mean age, 31.4 years) who had developed idiopathic scoliosis at the age of 10-18 years and underwent preoperative lumbar spine MRI at the age of ≥ 20 were included in the study. Twenty volunteers (3 men, 17 women; mean age, 33.6 years) without scoliosis were assessed as controls. We divided the adult scoliosis patients into two groups: Group A consisted of patients with lumbar modifier A, and Group BC consisted of those with modifiers B and C. IVD degeneration from L1/2 to L5/S1 was assessed by MRI. The Scoliosis Research Society-22 (SRS-22) patient questionnaire was used in the patients' clinical assessment.
There were 40 patients in the Group A and 62 in the Group BC. Compared to the control groups, significant IVD degeneration was observed at L2/3 and L3/4 in Group A, and at all levels except for L5/S1 in Group BC. The proportion of degenerated IVDs patients (Grades 1c and 2) was significantly higher in Group BC than those in Group A at L3/L4 and L4/L5. Furthermore, the severity of IVD degeneration was significantly greater in the group BC than in the group A at all levels, except for L5/S1, especially in patients aged > 30 years. The mean scores of all subdomains in the SRS-22 questionnaire were comparable between the two groups.
Our study showed that the residual lumbar curvature from AIS may have accelerated IVD degeneration in adulthood, especially in patients aged > 30 years.
III.
利用磁共振成像（MRI）阐明青少年特发性脊柱侧凸（AIS）患者脊柱畸形对成年后腰椎间盘（IVD）退变的影响。
本研究共纳入 102 例（8 名男性，94 名女性；平均年龄 31.4 岁）患者，这些患者在 10-18 岁时发生特发性脊柱侧凸，在≥20 岁时接受了术前腰椎 MRI 检查。20 名无脊柱侧凸的志愿者（3 名男性，17 名女性；平均年龄 33.6 岁）作为对照组。我们将成年脊柱侧凸患者分为两组：A 组患者存在腰椎校正器 A，BC 组患者存在校正器 B 和 C。通过 MRI 评估 L1/2 至 L5/S1 的 IVD 退变。患者的临床评估采用脊柱侧凸研究协会 22 项（SRS-22）患者问卷。
A 组有 40 例患者，BC 组有 62 例患者。与对照组相比，A 组在 L2/3 和 L3/4 可见明显的 IVD 退变，而 BC 组在除 L5/S1 之外的所有节段均可见明显的 IVD 退变。在 L3/L4 和 L4/L5 水平，BC 组退变 IVD 患者（等级 1c 和 2）的比例明显高于 A 组。此外，除 L5/S1 外，BC 组各节段 IVD 退变的严重程度均明显大于 A 组，尤其是年龄>30 岁的患者。SRS-22 问卷所有子领域的平均评分在两组之间无差异。
我们的研究表明，AIS 遗留的腰椎曲度可能加速了成年后的 IVD 退变，尤其是在年龄>30 岁的患者中。
III。
