Correlation Study Of Degenerative Lumbar Scoliosis With Radiological And Clinical Features

Objective: To observe radiological and clinical features of degenerative lumbarscoliosis，investigate their correlation and close degree, provide theoretical basis forprevention and treatment of degenerative lumbar scoliosis.Methods:1Degenerative lumbar scoliosis（DLS）62cases, male28cases, female34cases, age between35to73, average56.13±7.95,for DLS group, select60cases thatsame period and age and gender as control group.2Through history collection andphysical examination in DLS group, use low back pain VAS score and SRS-22scoreto assess the degree of pain and quality of life, observed and measured imagingparameters of patients（Lumbar scoliosis Cobb angle、lordosis、stability、top conerotation、 maximum displacement of the side of the adjacent vertebral、spondylolisthesis extent、the area of the lumbar intervertebral foramen、spinal canalarea）.3Use Two sample T-test for MRI spinal canal area of DLS group and controlgroup, paired sample T-test for left and right foraminal area of control group andpreoperative and postoperative date, use multiple linear regression for low back painVAS score、SRS-22score and imaging parameters of DLS group.Result:1.Clinical features: LDS group all62cases, average age56.13±7.95,51（82.3%）cases with history of underlying disease; history3months to25years, male27cases, female30cases, no significant difference between male and female（p>0.05）; Pain appear the concave side or the convex side of scoliosis, lower limbpain46cases（74.2%）；intermittent claudication22cases（35.5%）, lower extremitymuscle strength and felling diminish17cases（27.4%）.2. Imaging Characteristics: DLS patients scoliosis angle11.25to30.10,average 14.22°±3.16°；lordosis-8.25°to49.75°,average18.27±13.16°; convex to the left34cases, Convex to the right28cases, the direction of the convex side no obviousdifference（p>0.50）. Vertebral rotation≦Ⅱ56cases（90.3%）; vertebral instability41cases（66.1%）; lateral displacement>3mm39cases（62.9%）; vertebral sagittalbit slippage34cases（54.8%），spondylolisthesis all less than65%. Measurement oflumbar intervertebral foramen and spinal canal area, the concave side intervertebralforamen and spinal canal area、the convex side intervertebral foramen and spinal canalarea of DLS group less than control group, concave side of the intervertebral foramensignificantly reduced, the concave side foraminal area of DLS group less than theconvex side（p<0.05）.3. Lumbago has significant correlation with the maximum lateral displacement、thestability of lumbar spine、foraminal area、lumbar lordosis. Leg pain has significantcorrelation with foraminal area、cone of vertebral rotation、the area of the spinalcanal.Quality of life SRS-22score has significant correlation with foraminal area、thestability of lumbar spine、the area of the spinal canal、lumbar lordosis the maximumlateral displacement、cone of vertebral rotation.4. On the basis of full decompression and stabilization of spine,low back pain improvement ratehas significant correlation with the rate of correction of the maximum lateral displacementand lumbar lordosis. Leg pain improvement rate has significant correlation with the rate ofcorrection of cone of vertebral rotation and the lateral displacement. Quality of lifeSRS-22score has significant correlation with the rate of correction of lumbar lordosis、cone of vertebral rotation、the lateral displacement.Conclusion:1. Degenerative lumbar scoliosis occurs in old age, the Symptom mainlyinclude Lumbago(91.7%)、Lower limb pain(74.2%),some Lower limb of patient havethe Neural function damage(27.4%).2. The Imageology Characteristic of Degenerative lumbar scoliosis: scoliosis Cobbangle smaller, left scoliosis Roughly equal right scoliosis,often have the Apicalvertebra move to the side or Rotary subluxation、Sagittal plane of slippage and theLumbar lordosis angle reduce or Kyphosis. the area of Intervertebral foramen andspinal in Degenerative lumbar scoliosis are reduce, The area of concave side reduce more obvious than The convex side.3. The area of Intervertebral foramen、the Stability of spinal、the degree of rotationApical vertebra、the area of spinal、Lordosis angle have the Significant correlationwith Clinical.4. Operation Decompression fully, Stabilize the spine, restore Lumbar lordosisangle、improve the degree of rotation and Maximum Lateral displacement is theGuarantee of get good Treatment effect.