Investigation Of Degenerative Lumbar Scoliosis In Low Back Pain Patients

Objective:To investigate the general rules of degenerative lumbar scoliosis (DLS) in low back pain patients and analysis the relationship between the relevant parameters in DLS.Method:Analysis the anteroposterior radiographs of the low back pain patients,and measure the coronal Cobb angle,define Cobb angle more than 10°for scoliosis,the relationships between gender,age,direction,curve location,scoliosis segment,apex,upper and lower end vertebrae,the largest lateral listhesis,vertebral rotation,lumbar curvature and spondylolisthesis,were analyzed statistically.Result:2193 cases of patients with low back pain,there were 89 cases of DLS in 1000 standing radiography cases,while 123 cases of DLS in 1193 supine radiography cases,the age distribution of the two groups was basically the same, and prevalence was basically the same.Different position had no effect on the Cobb angle,apical rotation,the largest lateral listhesis,but had significantly effect on the lumbar curvature.In 2193 cases(male 758,female 1435),the prevalence of DLS was 9.7%(male 53,female 159),increasing with age,the prevalence of female was higher than male.In male,the prevalence significantly increased after 60-year-old,but in female,it is 50-year-old.Left side scoliosis were significantly more than right(138:74);lumbar scoliosis were found 181 cases,thoracolumbar scoliosis 31 cases.The Cobb angle ranged from 10°to 54.5°,in which 10°25°199 cases(93.9%),25°～35°9 cases(4.2%),35°～45°2 cases(0.9%),>45°2 cases(0.9%),scoliosis segment contained 3 to 5 vertebrae,most apex vertebra located L3(115 cases),140 cases had lateral listhesis(3～18.59mm),in which the largest listhesis vertebra was mostly the lower end vertebra.All cases of DLS had varying degrees of vertebral rotation,especiallyⅠorⅡdegree.Lumbar curvature: standing position,60.4°(lordosis)～13.6°(kyphosis);supine position, 64.7°(lordosis)～23.9°(kyphosis).95 cases had intervertebral instability,in which retrolisthesis 49 cases(mostly L2/3,L3/4),spondylolisthesis 46 cases (mostly L4/5,L5/S1).Conclusion:In low back pain patients,the prevalence of DLS increased with age,the onset age of female was earlier than male,left scoliosis was significantly more than right.Coronal Cobb angle,apex vertebra rotation and the largest lateral listhesis were positively correlation,while negative correlation with lumbar curvature.