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Impact of the flexibility of the spinal deformity on low back pain and disc degeneration in adult patients nonoperatively treated for adolescent idiopathic scoliosis with thoracolumbar or lumbar curves

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Abstract

Purpose

To evaluate the impact of the flexibility of thoracolumbar or lumbar (TL/L) curves on low back pain (LBP) and disc degeneration in adult patients nonoperatively treated for adolescent idiopathic scoliosis (AIS).

Methods

Forty-seven adult patients (46 women; mean age, 40.5 years) nonoperatively treated for AIS with TL/L curves were included. The patients completed radiological examinations, magnetic resonance imaging, and a questionnaire survey for LBP evaluation. The flexibility of the spinal deformity was evaluated using supine side-bending radiographs. Radiographic measurements were correlated with scores for LBP and disc degeneration.

Results

The average magnitude and flexibility of the TL/L curve were 49.0° and 56%, respectively. The magnitudes of the TL/L curve and disc wedging were significantly correlated with LBP (|r|= 0.3–0.4). The flexibility of the TL/L curve and disc wedging, and the lumbar lateral range of motion (ROM) were significantly correlated with LBP and disc degeneration (|r|= 0.3–0.5). After controlling for the magnitudes of the TL/L curve and disc wedging, the flexibility of L4/5 disc wedging and the lumbar lateral ROM remained significantly correlated with the Scoliosis Research Society-22 pain score (partial correlation coefficient [r′] = 0.5 and 0.3), Oswestry Disability Index (− 0.3 and − 0.3), and disc degeneration (− 0.4 and 0.3).

Conclusion

In AIS patients with TL/L curves, the flexibility of L4/5 disc wedging and the lumbar lateral ROM were significantly correlated with LBP and disc degeneration, independent of the magnitudes of the coronal deformities. Our findings indicate that maintaining or improving lumbar flexibility may be beneficial for preventing or treating LBP.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Funding

This work was supported by a grant from the Japan Orthopaedics and Traumatology Research Foundation Inc. (No. J16G0016).

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, 951-8510, Japan

    Masayuki Ohashi, Kei Watanabe, Keiichi Katsumi, Hideki Tashi, Yohei Shibuya & Hiroyuki Kawashima

  2. Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma City, Japan

    Toru Hirano

  3. Niigata Spine Surgery Center, Niigata City, Japan

    Kazuhiro Hasegawa

  4. Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, Niigata City, Japan

    Keiichi Katsumi

Authors
  1. Masayuki Ohashi
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  2. Kei Watanabe
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  3. Toru Hirano
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  4. Kazuhiro Hasegawa
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  5. Keiichi Katsumi
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  6. Hideki Tashi
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  7. Yohei Shibuya
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  8. Hiroyuki Kawashima
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Contributions

MO, KW, TH, KH, KK, HT, and YS: conception and design of the work; MO, KW, TH, KH, KK, HT, and YS: acquisition and analysis of data; HK: conceptual advice and supervision; MO, KW, TH, and KH: interpretation of data; MO, KW, TH, KH, KK, HT, YS, and HK: drafted the work; MO, KW, TH, KH, KK, HT, YS, and HK: substantively revised the work; MO, KW, TH, KH, KK, HT, YS, and HK: approved the submitted version.

Corresponding author

Correspondence to Masayuki Ohashi.

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Conflict of interest

The submitted manuscript does not contain any information about medical device(s)/drug(s). No relevant financial activities exist outside the submitted work.

Ethical approval

The study was approved by the ethics committee of the Niigata University Graduate School of Medical and Dental Sciences.

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The written informed consent was obtained from all patients.

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Ohashi, M., Watanabe, K., Hirano, T. et al. Impact of the flexibility of the spinal deformity on low back pain and disc degeneration in adult patients nonoperatively treated for adolescent idiopathic scoliosis with thoracolumbar or lumbar curves. Spine Deform 10, 133–140 (2022). https://doi.org/10.1007/s43390-021-00402-7

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  • DOI: https://doi.org/10.1007/s43390-021-00402-7

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