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Leg length discrepancy and adolescent idiopathic scoliosis: clinical and radiological characteristics

A Correction to this article was published on 26 November 2021

This article has been updated

Abstract

Purpose

This retrospective study aimed to present the clinical and radiological features of functional scoliosis due to LLD and LLD concurrent with AIS; it also aimed to define their relationships for differentiating functional scoliosis due to LLD and LLD concurrent with AIS.

Methods

This study was conducted as a single-center retrospective comparative study on 47 scoliosis patients with diagnosed LLD, aged 10–18 years. Cases with a diagnosis of structural LLD were divided into two groups according to the presence or absence of concurrent AIS. Data on demographics and the angle of trunk rotation on a sacral basis (ATRsacrum) were recorded. Limb length was clinically measured with a tape measure and clinical LLD (C-LLD) scoliometer test. Cobb angle, axial rotation, pelvic obliquity, and radiological LLD (R-LLD) were obtained from standing spine radiographs and measured by two blinded orthopedic spine surgeons.

Results

The prevalence of LLD was 6.7% in scoliosis patients in our study population. Cobb angle and apical rotation were higher in the LLD concurrent with AIS group than in the LLD group (p ≤ 0.05). The C-LLDscoliometer test results were strongly correlated with both C-LLDtape measure (r = 0.651; p = 0.000) and ATRsacrum (r = 0.688; p = 0.000).

Conclusion

LLD may develop as a result of adaptive changes due to scoliosis, or a concurrent condition to scoliosis. Cobb angle and apical rotation are the features that differentiate AIS from functional scoliosis in patients with LLD. The C-LLD scoliometer test can be an effective, practical, and useful method for measuring C-LLD, but its validity and reliability should be determined.

Trial registration

This study was retrospectively registered at ClinicalTrials.gov (number: NCT04713397, date of registration: 01/14/2021).

Level of evidence

III.

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Change history

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Funding

No funding was received for this study.

Author information

Affiliations

Authors

Contributions

AB, KA, HB, HY: Made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work. Drafted the work or revised it critically for important intellectual content. Approved the version to be published. Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Ahsen Buyukaslan.

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Conflict of interest

The authors declare no conflict of interest.

Ethics approval

The study was approved by the Ethical Committee of Halic University, Istanbul (date: 28.12.2018, issue no: 171-30 number).

Additional information

The original online version of this article was revised: In Fig. 2 of this article, there was a label reading "0.7 mm" instead of "0.7 cm".

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Buyukaslan, A., Abul, K., Berk, H. et al. Leg length discrepancy and adolescent idiopathic scoliosis: clinical and radiological characteristics. Spine Deform (2021). https://doi.org/10.1007/s43390-021-00417-0

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Keywords

  • Leg length discrepancy
  • Scoliosis
  • Pelvic obliquity
  • Leg length discrepancy scoliometer test