Residual lumbar curvature that developed during adolescence accelerates intervertebral disc degeneration in adulthood

Spine Deform. 2021 May;9(3):711-720. doi: 10.1007/s43390-020-00252-9. Epub 2020 Nov 27.

Abstract

Purpose: 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).

Methods: 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.

Results: 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.

Conclusion: Our study showed that the residual lumbar curvature from AIS may have accelerated IVD degeneration in adulthood, especially in patients aged > 30 years.

Level of evidence: III.

Keywords: Adolescent idiopathic scoliosis; Adulthood; Intervertebral disc degeneration; Lumbar curvature; Magnetic resonance imaging.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Humans
  • Intervertebral Disc Degeneration* / diagnostic imaging
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbosacral Region
  • Magnetic Resonance Imaging
  • Male
  • Scoliosis* / diagnostic imaging
  • Scoliosis* / etiology