title: Factors predicting progression in early degenerative lumbar scoliosis.
abstract: OBJECTIVE
  To review early radiographs of patients with de novo degenerative lumbar scoliosis to determine factors predicting early scoliosis progression.
  
  
  METHODS
  Standing anteroposterior and lateral radiographs of 7 men and 20 women aged 48 to 83 (mean, 63) years with Cobb angles between >5º and <20º were reviewed. They were followed up for a mean of 12 (range, 10-18) years. Radiographic variables measured included (1) the Cobb angle, (2) the grade of rotation of the apical lumbar vertebra, (3) the presence of a lateral vertebral translation of ≥3 mm, (4) the degree of osteoporosis, and (5) the Harrington factor (the degree of scoliosis divided by the number of vertebrae involved).
  
  
  RESULTS
  During the follow-up period, the mean Cobb angle increased 5.3º from 10.1º to 15.4º, representing an increase of 0.4º per year. In initial radiographs, the apical vertebral rotation was rated as grade 0 in 3 patients, grade 1 in 19, grade 2 in 4, and grade 3 in one. A lateral vertebral translation of ≥3 mm was noted in 9 patients. The degree of osteoporosis was rated as grade 0 in 9 patients, grade 1 in 11, grade 2 in 5, and grade 3 in 2. The mean Harrington factor was 2.4. In the multiple regression analysis, only the grade of apical vertebral rotation was significantly correlated with scoliosis progression (regression coefficient=0.502, p=0.009).
  
  
  CONCLUSIONS
  Apical vertebral rotation may help predict the scoliosis progression and determine the timing of surgical intervention in patients with early degenerative lumbar scoliosis.
authors.affiliation: Department of Orthopaedic Surgery, Kochi Medical School, Kohasu Oko-cho, Nankoku City, Kochi, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kohno
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ikeuchi
authors.forename: Shinichirou
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Takemasa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000473:pathology