title: Do the disc degeneration and osteophyte contribute to the curve rigidity of degenerative scoliosis?
abstract: The factors associated with lateral curve flexibility in degenerative scoliosis have not been well documented. Disc degeneration could result in significant change in stiffness and range of motion in lateral bending films. The osteophytes could be commonly observed in degenerative spine but the relationship between osteophyte formation and curve flexibility remains controversial. The aim of the current study is to clarify if the disc degeneration and osteophyte formation were both associated with curve flexibility of degenerative scoliosis.
  
  
  
  A total of 85 patients were retrospectively analyzed. The inclusion criteria were as follow: age greater than 45 years, diagnosed as degenerative scoliosis and coronal Cobb angle greater than 20°. Curve flexibility was calculated based on Cobb angle, and range of motion (ROM) was based on disc angle evaluation. Regional disc degeneration score (RDS) was obtained according to Pfirrmann classification and osteophyte formation score (OFS) was based on Nanthan classification. Spearman correlation was performed to analyze the relationship between curve flexibility and RDS as well as OFS.
  
  
  
  Moderate correlation was found between RDS and curve flexibility with a Spearman coefficient of -0.487 (P = 0.009). Similarly, moderate correlation was observed between curve flexibility and OFS with a Spearman coefficient of -0.429 (P = 0.012). Strong correlation was found between apical ROM and OFS compared to the relationship between curve flexibility and OFS with a Spearman coefficient of -0.627 (P < 0.001).
  
  
  
  Both disc degeneration and osteophytes formation correlated with curve rigidity. The pre-operative evaluation of both features may aid in the surgical decision-making in degenerative scoliosis patients.
authors.affiliation: Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China. gulouspine@gmail.com.|Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong, China. gulouspine@gmail.com.|Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, Nanjing, China. gulouspine@gmail.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.|Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, Nanjing, China.
authors.forename: Hongda
authors.initials: H
authors.lastname: Bao
authors.affiliation: Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.|Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, Nanjing, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Yan
authors.affiliation: Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.|Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, Nanjing, China.
authors.forename: Shunan
authors.initials: S
authors.lastname: Liu
authors.affiliation: Geisel School of Medicine, Dartmouth College, Hanover, NH, USA.
authors.forename: Mike
authors.initials: M
authors.lastname: Bao
authors.affiliation: Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.|Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, Nanjing, China.
authors.forename: Zezhang
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.|Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, Nanjing, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.|Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, Nanjing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Qiu
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D054850:Osteophyte / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*
keywords: Curve flexibility; Degenerative scoliosis; Disc degeneration; Osteophyte