European Spine Journal

, Volume 20, Issue 12, pp 2223–2227 | Cite as

The impact of lumbar scoliosis on pain, function and health-related quality of life in postmenopausal women

  • Julio UrrutiaEmail author
  • Julio Espinosa
  • Claudio Diaz-Ledezma
  • Carlos Cabello
Original Article


The impact of adult scoliosis on pain, function and health-related quality of life (QOL) has not been clearly defined. A population-based study using widely applied screening tools could better reflect the impact of adult scoliosis. In this study, a visual analog pain scale assessment (VAS) for lumbar and leg pain, an Oswestry disability index (ODI) and a standard version of the Medical Outcome Study Short Form-36 (SF-36) questionnaire were sent by mail to 261 women of age 50 years and older, consecutively evaluated with dual-energy radiograph absorptiometry (DXA) scan images. 138 patients (32 with lumbar curves 10° or bigger) returned the questionnaires. Differences in lumbar VAS, leg VAS, ODI and SF-36 values between groups of patients with curves <10°, 10°–19° and ≥20° were evaluated. Correlation analyses of the Cobb angle, age and body mass index (BMI) with VAS, ODI and SF-36 values, and multivariate regression analysis were performed. Patients with curves <10°, 10°–19° and ≥20° had no significant differences in lumbar or leg VAS, ODI or SF-36 values. ODI values correlated with age and BMI; SF-36 values correlated with BMI only; lumbar and leg VAS values did not correlate with lumbar curvature, age or BMI. Regression disclosed that Cobb angle values did not influence ODI, SF-36 or VAS values. In postmenopausal women with mild and moderate lumbar curves, Cobb angle had no influence on pain, function and QOL; age and BMI had small effect.


Adult scoliosis Pain Disability Health-related quality of life 



The authors thank Jose Romeo, PhD in Statistics, Department of Mathematics, Universidad de Santiago de Chile, for statistical support.


  1. 1.
    Bridwell KH (2004) Selection of instrumentation and fusion levels for scoliosis: where to start and where to stop. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves. J Neurosurg Spine 1:1–8. doi: 10.3171/spi.2004.1.1.0001 PubMedCrossRefGoogle Scholar
  2. 2.
    Bridwell KH, Berven S, Edwards C 2nd, Glassman S, Hamill C, Schwab F (2007) The problems and limitations of applying evidence-based medicine to primary surgical treatment of adult spinal deformity. Spine 32:S135–S139. doi: 10.1097/BRS.0b013e3181453e22 PubMedCrossRefGoogle Scholar
  3. 3.
    Glassman SD, Berven S, Bridwell K, Horton W, Dimar JR (2005) Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine 30:682–688. doi: 00007632-200503150-00016 PubMedCrossRefGoogle Scholar
  4. 4.
    Berven SH, Deviren V, Mitchell B, Wahba G, Hu SS, Bradford DS (2007) Operative management of degenerative scoliosis: an evidence-based approach to surgical strategies based on clinical and radiographic outcomes. Neurosurg Clin N Am 18:261–272. doi: 10.1016/ PubMedCrossRefGoogle Scholar
  5. 5.
    Ploumis A, Liu H, Mehbod AA, Transfeldt EE, Winter RB (2009) A correlation of radiographic and functional measurements in adult degenerative scoliosis. Spine 34:1581–1584. doi: 10.1097/BRS.0b013e31819c94cc PubMedCrossRefGoogle Scholar
  6. 6.
    Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV (2003) Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA 289:559–567. doi: joc21444 PubMedCrossRefGoogle Scholar
  7. 7.
    Weinstein SL, Zavala DC, Ponseti IV (1981) Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am 63:702–712PubMedGoogle Scholar
  8. 8.
    Schwab F, Dubey A, El Fegoun AB, Hwang K, Pagala M, Farcy JP (2005) Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine 30:1082–1085. doi: 00007632-200505010-00017 PubMedCrossRefGoogle Scholar
  9. 9.
    Kostuik JP, Bentivoglio J (1981) The incidence of low-back pain in adult scoliosis. Spine 6:268–273PubMedCrossRefGoogle Scholar
  10. 10.
    Jackson RP, Simmons EH, Stripinis D (1983) Incidence and severity of back pain in adult idiopathic scoliosis. Spine 8:749–756PubMedCrossRefGoogle Scholar
  11. 11.
    Epstein JA, Epstein BS, Jones MD (1979) Symptomatic lumbar scoliosis with degenerative changes in the elderly. Spine 4:542–547PubMedCrossRefGoogle Scholar
  12. 12.
    Perennou D, Marcelli C, Herisson C, Simon L (1994) Adult lumbar scoliosis. Epidemiologic aspects in a low-back pain population. Spine 19:123–128PubMedCrossRefGoogle Scholar
  13. 13.
    Urrutia J, Diaz-Ledezma C, Espinosa J, Berven S (2011) Lumbar scoliosis in postmenopausal women: prevalence and relationship with bone density, age, and body mass index. Spine (Phila Pa 1976) 36:737–740. doi: 10.1097/BRS.0b013e3181db7456 Google Scholar
  14. 14.
    Schwab FJ, Smith VA, Biserni M, Gamez L, Farcy JP, Pagala M (2002) Adult scoliosis: a quantitative radiographic and clinical analysis. Spine 27:387–392PubMedCrossRefGoogle Scholar
  15. 15.
    Robin GC, Span Y, Steinberg R, Makin M, Menczel J (1982) Scoliosis in the elderly: a follow-up study. Spine 7:355–359PubMedCrossRefGoogle Scholar
  16. 16.
    Hong JY, Suh SW, Modi HN, Hur CY, Song HR, Park JH (2010) The prevalence and radiological findings in 1,347 elderly patients with scoliosis. J Bone Joint Surg Br 92:980–983. doi: 10.1302/0301-620X.92B7.23331 PubMedCrossRefGoogle Scholar
  17. 17.
    Glassman SD, Copay AG, Berven SH, Polly DW, Subach BR, Carreon LY (2008) Defining substantial clinical benefit following lumbar spine arthrodesis. J Bone Joint Surg Am 90:1839–1847. doi: 10.2106/JBJS.G.01095 PubMedCrossRefGoogle Scholar
  18. 18.
    Copay AG, Martin MM, Subach BR, Carreon LY, Glassman SD, Schuler TC, Berven S (2010) Assessment of spine surgery outcomes: inconsistency of change amongst outcome measurements. Spine J 10:291–296. doi: 10.1016/j.spinee.2009.12.027 PubMedCrossRefGoogle Scholar
  19. 19.
    Benoist M (2003) Natural history of the aging spine. Eur Spine J 12(Suppl 2):S86–S89. doi: 10.1007/s00586-003-0593-0 PubMedCrossRefGoogle Scholar
  20. 20.
    Daffner SD, Vaccaro AR (2003) Adult degenerative lumbar scoliosis. Am J Orthop (Belle Mead NJ) 32:77–82 discussion 82Google Scholar
  21. 21.
    Collis DK, Ponseti IV (1969) Long-term follow-up of patients with idiopathic scoliosis not treated surgically. J Bone Joint Surg Am 51:425–445PubMedGoogle Scholar
  22. 22.
    Weinstein SL, Ponseti IV (1983) Curve progression in idiopathic scoliosis. J Bone Joint Surg Am 65:447–455PubMedGoogle Scholar
  23. 23.
    Leboeuf-Yde C, Nielsen J, Kyvik KO, Fejer R, Hartvigsen J (2009) Pain in the lumbar, thoracic or cervical regions: do age and gender matter? A population-based study of 34, 902 Danish twins 20–71 years of age. BMC Musculoskelet Disord 10:39. doi: 10.1186/1471-2474-10-39 PubMedCrossRefGoogle Scholar
  24. 24.
    Dionne CE, Dunn KM, Croft PR (2006) Does back pain prevalence really decrease with increasing age? A systematic review. Age Ageing 35:229–234. doi: 10.1093/ageing/afj055 PubMedCrossRefGoogle Scholar
  25. 25.
    Leboeuf-Yde C (2000) Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine 25:226–237 Phila Pa 1976PubMedCrossRefGoogle Scholar
  26. 26.
    Mirtz TA, Greene L (2005) Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question. Chiropr Osteopat 13:2. doi: 10.1186/1746-1340-13-2 PubMedCrossRefGoogle Scholar
  27. 27.
    Heuch I, Hagen K, Nygaard O, Zwart JA (2010) The impact of body mass index on the prevalence of low back pain: the HUNT study. Spine 35:764–768. doi: 10.1097/BRS.0b013e3181ba1531 PubMedGoogle Scholar
  28. 28.
    Pappou IP, Girardi FP, Sandhu HS, Parvataneni HK, Cammisa FP, Cammisa FP Jr, Schneider R, Frelinghuysen P, Lane JM (2006) Discordantly high spinal bone mineral density values in patients with adult lumbar scoliosis. Spine 31:1614–1620. doi: 10.1097/01.brs.0000222030.32171.5f PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Julio Urrutia
    • 1
    Email author
  • Julio Espinosa
    • 1
  • Claudio Diaz-Ledezma
    • 2
  • Carlos Cabello
    • 1
  1. 1.Department of Orthopaedic SurgeryPontificia Universidad Catolica de ChileSantiagoChile
  2. 2.Universidad del DesarrolloSantiagoChile

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