title: Scoliosis in adults aged forty years and older: prevalence and relationship to age, race, and gender.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To identify the prevalence of lumbar scoliosis in adults ≥ 40 years old; to investigate relationships between scoliosis prevalence and 3 parameters (age, race, gender); and to determine any effect of those parameters on curve severity.
  
  
  BACKGROUND
  As the population ages, the incidence of degenerative spine conditions increases. More patients are being diagnosed with and treated for spinal deformities, including scoliosis.
  
  
  METHODS
  We examined dual-energy x-ray absorptiometry lumbar spine images of 3185 individuals ≥ 40 years old (average, 60.8 years; range, 40-97 years), obtained July 2002 to June 2005, to determine the presence of scoliosis (i.e., a curvature of ≥ 11.0°) by digitally measuring Cobb angles. Patients with a history of previous lumbar spinal surgery were excluded, leaving 2973 individuals for final evaluation. We used SAS system software, version 9.1 (SAS Institute, Inc., Cary, NC) to investigate the relationship between the prevalence of scoliosis and the variables of age, race, and gender, we then examined for any effect that these variables had on curve severity.
  
  
  RESULTS
  We identified scoliosis (i.e., a Cobb angle of ≥ 11°) in 263 of 2973 patients. Age was associated with an increased prevalence of scoliosis, e.g., 40 to 50 years old, 3.14%; ≥ 90 years old, 50%. Prevalence rates differed among races (e.g., 11.1% for whites and 6.5% for African Americans) but were similar for men and women. Most patients had mild curves (80.6%), there was no difference in the distribution of curve severity by gender or age, and African Americans were more likely to have mild curves (94.3%) than were other races.
  
  
  CONCLUSIONS
  The prevalence of scoliosis in our patients ≥ 40 years old was 8.85% and was associated with age and race, but not with gender. Most curves in our population were mild; curve severity was associated with race but not with age or gender.
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA. ehenze1@jhmi.edu
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Kebaish
authors.forename: Philip R
authors.initials: PR
authors.lastname: Neubauer
authors.forename: Gabor D
authors.initials: GD
authors.lastname: Voros
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Khoshnevisan
authors.forename: Richard L
authors.initials: RL
authors.lastname: Skolasky
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000208:ethnology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data