A Lumbar Classification of Scoliosis in the Adult Patient: Preliminary Approach

Schwab, Frank J.; el-Fegoun, Abdelkrim Benchick; Gamez, Lorenzo; Goodman, Howard J.; Farcy, Jean-Pierre C.

doi:10.1097/01.brs.0000170293.81234.f0

Cited by 101 publications

(51 citation statements)

References 12 publications

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“…Previous studies have been contradictory on the relationship between scoliosis and symptoms [4,17,19,20]. We have not set out to and are not able to make any comment on the relationship between the presence of deformity and symptoms.…”

Section: Discussionmentioning

confidence: 82%

“…Previous studies have looked at the prevalence of lumbar scoliosis in symptomatic and non-symptomatic groups. Prevalence has ranged from 1.4-68% [2][3][4][5]. The prevalence of spondylolisthesis in the sagittal plane has been investigated by other authors [6,7] but coronal plane deformity, and in particular lateral listhesis, has not been well characterised.…”

Section: Introductionmentioning

confidence: 99%

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Abnormalities of the lumbar spine in the coronal plane on plain abdominal radiographs

Kilshaw¹,

Baker²,

Gardner³

et al. 2010

Eur Spine J

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The main objective of this study is to determine the prevalence of coronal abnormalities of the lumbar spine in a large population of patients with respect to their age and sex. Lumbar degenerative disease is associated with degenerative scoliosis. Degenerative scoliosis and lateral listhesis are important features to identify before decompressive surgery as deformity may not be seen on magnetic resonance imaging scans. Scoliosis and lateral listhesis may be important in the development of symptoms especially in an ageing population. All abdominal and plain kidney-ureter-bladder radiographs performed over a 10-month period were reviewed. 2,765 radiographs were assessed for scoliosis (Cobb angle greater then 10°), lateral listhesis and evidence of osteoarthritis. The prevalence of scoliosis, lateral listhesis and osteoarthritis of the lumbar spine increased with age. Scoliosis and lateral listhesis were significantly more prevalent in women. Deformity starts to occur after the age of 50 and steadily increases with age. By the ninth decade nearly a quarter of patients have evidence of scoliosis and lateral listhesis. As the adult lumbar spine ages, the prevalence of lateral listhesis and degenerative scoliosis increases. It is important to appreciate these coronal abnormalities in patients undergoing decompressive surgery for spinal stenosis. This increase in deformity may have a greater impact as the population continues to age.

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Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Abnormalities of the lumbar spine in the coronal plane on plain abdominal radiographs

Kilshaw¹,

Baker²,

Gardner³

et al. 2010

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…The Schwab grading system was used to classify the deformity as it has recently been validated and shown to have excellent inter-and intra-observer reliability [25][26][27]. In this series, only one observer was used to classify the deformity (A Irwin).…”

Section: Discussionmentioning

confidence: 99%

“…All patients were consented and Caldicott approval gained. Patients with radiographic evidence of spinal deformity were analysed separately and their lumbar deformity graded using the Schwab grading system [25][26][27] (Table 1; Fig. 3).…”

Section: Methodsmentioning

confidence: 99%

The role of needle tip position on the accuracy of diagnostic selective nerve root blocks in spinal deformity

et al. 2014

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“…Current classifications of adult deformity [1,[8][9][10][11], have outlined the etiological aspects of adult deformity and outcome-related morphological aspects, improving our comprehension of the pathology, informing about the cause of the deformity (Aebi's classification) or establishing criteria of severity of the curve (Schwab's classification). One of the limitations of the current classifications is their inability to identify candidates for selective fusion of one area of the curve or to assist the surgeon with surgical planning.…”

Section: Introductionmentioning

confidence: 99%

Classification of degenerative segment disease in adults with deformity of the lumbar or thoracolumbar spine

Berjano

Lamartina

2014

Eur Spine J

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Background Lumbar and thoracolumbar deformity in the adult is a condition with impairment of health status that can need surgical treatment. In contrast with adolescent deformity, where magnitude of the curve plays a significant role in surgical indication, the aspects relevant in adult deformity are pain and dysfunction that correlate with segment degeneration and imbalance. Previous classifications of adult deformity have been of little use for surgical planning. Methods Chart review and classification of radiographic and clinical findings. A classification of degenerative disc disease based on distribution of diseased segments and balance status of the spine is presented. Results Four main categories are presented: Type I (limited nonapical segment disease), Type II (limited apical segment disease), Type III (extended segment disease-apical and nonapical), Type IV (imbalanced spine: IVa, sagittally imbalanced; IVb, sagittally and coronally imbalanced). Discussion and conclusion Types I and II can be treated by fusion of a selective area of the curve. Type III needs fusion of all the extension of the coronal curve. Type IV usually needs aggressive corrective procedures, frequently including posterior tricolumnar osteotomies. This classification permits interpreting the extension and magnitude of the disease and can help establish a surgical plan regarding selective fusion and methods of sagittal correction. Future research is needed to validate the classification.

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A Lumbar Classification of Scoliosis in the Adult Patient: Preliminary Approach

Cited by 101 publications

References 12 publications

Abnormalities of the lumbar spine in the coronal plane on plain abdominal radiographs

Abnormalities of the lumbar spine in the coronal plane on plain abdominal radiographs

The role of needle tip position on the accuracy of diagnostic selective nerve root blocks in spinal deformity

Classification of degenerative segment disease in adults with deformity of the lumbar or thoracolumbar spine

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