Adolesan İdiopatik Skolyozda Lumbosakral Sagittal Omurga Diziliminin Analizi: 10 Yıllık Retrospektif Veri İncelemesi

Öz

Bu çalışmanın amacı adölesan idiyopatik skolyozlu (AİS) hastalarda lumbosakral sagittal dizilimi araştırmaktır. Çalışmaya on yıllık bir dönemdeki (Ocak 2013 ile Ocak 2023 arası) 10-18 yaş arası AIS hastalarının verileri dahil edilmiştir. Dijitalleştirilmiş radyografiler kullanılarak, Cobb açısı, Risser evrelemesi, intervertebral disk açıları, lomber lordoz açısı, lumbosakral lordoz açısı, lumbosakral açı, sakral tilt ve disk yükseklikleri dahil olmak üzere sagital ve koronal spinal parametreler ölçülmüş ve analiz edilmiştir. Hastalar Cobb açısına göre yüksek (≥23,8°) ve düşük (<23,8°) açı gruplarına ayrılmıştır. Toplam 1102 skolyoz radyografi uygunluk açısından değerlendirilmiştir. Bunlardan 122 hasta (%73'ü kadın) analizlere dahil edilmiştir. Ortanca yaş ve Cobb açısı sırasıyla 14 (4) yıl ve 23,8 (13,9) derece idi. Hastaların büyük çoğunluğunda (%43,4) torasik eğrilik vardı. En sık gözlenen Risser evresi 4 (n=48) idi. Cobb açısı ≥23,8° olan hastalarda, Cobb açısı <23,8° olanlara kıyasla L5-S1 intervertebral disk yükseklikleri anlamlı derecede düşüktü (p=0,014). Diğer sagital parametrelerde, yüksek ve düşük Cobb açısı grupları arasında anlamlı bir fark gözlenmemiştir. AİS hastalarında, yüksek Cobb açısına sahip olanlar düşük Cobb açılı gruba kıyasla daha düşük L5-S1 intervertebral disk yüksekliğine sahiptir. Disk yüksekliğinin azalması potansiyel disk dejenerasyonu veya herniasyonunun erken bir göstergesi olabileceğinden, yüksek açılı AİS hastalarının daha yakından izlenmesi gerekecektir. Bu çalışma, yüksek eğrilik açısına sahip AİS hastalarında gelecekteki kas-iskelet sistemi risklerini önlemek için erken değerlendirmenin önemini vurgulamaktadır.

Anahtar Kelimeler

• Adolesan
• skolyoz
• intervertebral disk
• intervertebral disk dejenerasyonu
• disk hernisi

Analysis of Lumbosacral Sagittal Spinal Alignment in Adolescent Idiopathic Scoliosis: A 10-Year Retrospective Data Review

Öz

This study aimed to investigate lumbosacral sagittal alignment in patients with adolescent idiopathic scoliosis (AIS). The study included data of patients with AIS aged 10-18 years from a ten-year period (between January 2013 and January 2023). Using digitized radiographies, sagittal and coronal spinal parameters including Cobb angle, Risser staging, intervertebral disc angles, lumbar lordosis angle, lumbosacral lordosis angle, lumbosacral angle, sacral tilt and disc heights were measured and analyzed. Patients were categorized based on the Cobb angle into high (≥23.8°) and low (<23.8°) angle groups. Results: A total of 1102 scoliosis x-rays have been evaluated for eligibility. Of those, 122 patients (73% female) were included in the analyses. The median age and Cobb angle were 14 (4) years and 23.8 (13.9) degrees, respectively. Majority of the patients (43.4%) had thoracic curvature. The most frequently observed Risser grade was 4 (n=48). Patients with a Cobb angle ≥23.8° exhibited significantly lower L5-S1 intervertebral disc heights when compared to those with a Cobb angle <23.8° (p=0.014). No significant differences were observed in other sagittal parameters between high and low Cobb angle groups. In patients with AIS, those with high Cobb angle have lower L5-S1 intervertebral disc heights compared to the low Cobb angle group. Since reduced disc height may serve as an early indicator of potential disc degeneration or herniation, high-angle AIS patients would require closer monitoring. The study emphasizes the importance of early assessment to prevent future musculoskeletal risks in AIS patients with higher curvature angles

Anahtar Kelimeler

• Adolescent
• Scoliosis
• Intervertebral disc
• Intervertebral disc degeneration
• Disc herniation

Kaynakça

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