| Objective: To evaluate the correlation between changes in radiographic parameters and Health Related Quality of Life in adult scoliosis patients.Methods: A total of 25 patients with adult scoliosis were treated in the department of orthopaedics in the first Affiliated Hospital of Chongqing Medical University between january 2012 and december 2010,including 9males and 16 females,at the age of 18 to 77 years old, averagely 47.5±10.3years old.Before surgery and during final follow-up,all patients were photographed at posteroanterior and lateral positions using X-ray.Complete Oswestry Disability Index data were collected.Measurements included plumbline offset from C7 to midsacral(C7-CSVL), Cobb scoliosis angle,maximal lateral olisthesis,L3 endplate obliquity angle, sagittal vertical axis(SVA), lumbar lordosis(LL),thoracic kyphosis(TK), pelvic incidence(PI), sacral slope(SS), pelvic tilt(PT), pelvic incidence-lumbar lordosis(PI-LL), T1-spinopelvic inclination(T1-SPI) and degrees ofvertebral rotation. Correlation of radiological parameters and Oswestry Disability Index(ODI) values was analyzed using pearson’s correlation analysis.Results: Significant differences in Oswestry Disability Index score were visible between preoperation(39.2±12.3) and postoperation(19.5±9.4)(P < 0.05).On the coronal plane,mean Cobb angle was reduced from 36.1°preoperatively to 10.6° postoperatively. Lateral olisthesis was reduced from4.9 mm to almost zero in most patients.And mean L3 endplate obliquity angle was reduced from 20.9° to 8.6°. Lateral olisthesis and L3 endplate obliquity angle was correlated to ODI score both preoperatively. On the sagittal plane, SVA, T1-SPI and PT was correlated to ODI score preoperatively(p<0.05,r=0.31; p<0.05,r=0.37; p<0.05,r=0.15). After surgery,LL,SVA,T1-SPI and PI-LL was correlated to ODI score p<0.05,r=-0.12;p<0.05r=0.30;p<0.05,r=0.35;p<0.05,r=0.25).degrees of vertebral rotation was correlated to ODI score preoperatively and postoperatively(p<0.05).Conclusions: Developpng the scoliosis surgery strategy not only pay attention to the sagittal imbalance,but also to the coronal and axial rotation deformity.The surgery of scoliosis deformity should focus on three-dimensional reconstruction of spinal balance,particularly on the correction of sagittal balance in order to relief the clinical symptoms and improve the patient’s quality of life.T1-SPI was better than SVA to evaluate the correlation between HRQOL and sagittal balance,especially withregional sagittal balance.The improvement of the radiographic parameters can not predict the relief of symptoms.Adult scoliosis showed high PT and low SS was more commmon.Surgery can be effective in increasing SS and lower PT. |
