Correlation Analysis Between Radiographic Parameters And Clinical Symptoms And The Quality Of Life In Adult Scoliosis

Objectives1、To analyze the correlation between cornal balance、sagittal balance and axialrotation.2、To evaluate the correlation between the parameters of spinal balance and VAS,SF-12domains.Method1、Radiographic analysis for35patients with adult scoliosis recuited from thepatients who consulted in orthopedics department of Fuzhou General Hospital ofNanjing Military Command(9male and26female patients；age range,22-71years，average age,40-years). Every patient has posteroanterior and lateral standingradiographs. The measurement parameters included: Coronal plane: Cobb scoliosisangle, plumbline offset from C7to midsacral, maximal lateral olisthesis, L3endplateobliquity angle; Sagittal plane: thoracic kyphosis(TK), thoracolumbar kyphosis(TLK),lumbar lordosis(LL), plumbline offset from C7to posterosuperior corner of the S1vertebral body, pelvic tilt(PT), pelvic incidence(PI), and sacral slope(ss); horizontalplane: degrees of vertebral rotation. Correlation statistical analysis was performedbetween every two radiographic parameters with Pearson’s method.2、Clinical symptoms were measured with Oswestry Disability Index, and thequality of life was measured with SF-12. Correlation between clinical data andradiographic data were then calculated.Results1、 C7-CSVL had a significant correlation with SVA(r=0.790，P=0.036<0.05),.Vertebral rotation had a significant correlation with maximal lateral olisthesis and LL（r=0.548，P=0.042<0.05；r=-0.332，P=0.017<0.05). LL had a significant correlationwith maximal lateral olisthesis、SS and PI(r=-0.654，P=0.029<0.05；r=0.608， P=0.047<0.05；r=0.532，P=0.037<0.05). Significant correlation between PT and L3endplate obliquity（r=0.657，P=0.028<0.05）. There was a geometrical ralationship inpelvis parameters: PI=SS+PT. And, significant negative correlation could be foundbetween SS and PT（r=-0.583，P=0.016<0.05）.2、There was a significant positive correlation between L3endplate obliquity andmaximal lateral olisthesis（r=0.543，P=0.031<0.05；r=0.25，P=0.035<0.05）.But nocorrelation was found between C7-CSVL and ODI, coronal Cobb angle and ODI（r=-0.338，P=0.65>0.05；r=0.159，P=0.117>0.05）.3、 In sagittal plane, LL、 SVA、 PT all had significant correlation withODI(r=-0.370，P=0.015<0.05；r=0.606，P=0.025<0.05；r=0.381，P=0.047<0.05), andSVA show the most significant correlation. Significant correlation could be foundbetween LL、 SS、 PT and SF-12MCS （r=0.470， P=0.034<0.05； r=0.430，P=0.037<0.05；r=0.40,P=0.021<0.05）. Then, there was a significant correlationbetween SVA、PT and SF-12PCS（r=-0.670，P=0.010=0.01；r=0.391，P=0.04<0.05）.4、There was a significant positive correlation between vertebral rotation andODI（r=0.41，P=0.043<0.05）.Conclusions1、This study confirms that coronal balance has correlation with sagittal balance,and vertebral is an influencing factor to local stability instead to major balance ofspine.2、SS and PT are two key parameters in regulating sagittal balance.3、Local rotational instability、sagittal imbalance、the loss of lumbar lordosis andPT are the key parameters which can affect clinical symptoms and the quality oflife.Correcting these parameters and keeping appropriate PT while treating adultscoliosis are important for a better life quality.