• Spine · Mar 2005

    Multicenter Study

    Correlation of radiographic parameters and clinical symptoms in adult scoliosis.

    • Steven D Glassman, Sigurd Berven, Keith Bridwell, William Horton, and John R Dimar.
    • Department of Orthopaedic Surgery, University of Louisville School of Medicine and the Kenton D. Leatherman Spine Center, Louisville, KY, USA. tallgeyer@spinemds.com
    • Spine. 2005 Mar 15; 30 (6): 682-8.

    Study DesignThis study is a retrospective review of the initial enrollment data from a prospective multicentered study of adult spinal deformity.ObjectivesThe purpose of this study is to correlate radiographic measures of deformity with patient-based outcome measures in adult scoliosis.Summary Of Background DataPrior studies of adult scoliosis have attempted to correlate radiographic appearance and clinical symptoms, but it has proven difficult to predict health status based on radiographic measures of deformity alone. The ability to correlate radiographic measures of deformity with symptoms would be useful for decision-making and surgical planning.MethodsThe study correlates radiographic measures of deformity with scores on the Short Form-12, Scoliosis Research Society-29, and Oswestry profiles. Radiographic evaluation was performed according to an established positioning protocol for anteroposterior and lateral 36-inch standing radiographs. Radiographic parameters studied were curve type, curve location, curve magnitude, coronal balance, sagittal balance, apical rotation, and rotatory subluxation.ResultsThe 298 patients studied include 172 with no prior surgery and 126 who had undergone prior spine fusion. Positive sagittal balance was the most reliable predictor of clinical symptoms in both patient groups. Thoracolumbar and lumbar curves generated less favorable scores than thoracic curves in both patient groups. Significant coronal imbalance of greater than 4 cm was associated with deterioration in pain and function scores for unoperated patients but not in patients with previous surgery.ConclusionsThis study suggests that restoration of a more normal sagittal balance is the critical goal for any reconstructive spine surgery. The study suggests that magnitude of coronal deformity and extent of coronal correction are less critical parameters.

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