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

Yıl 2025, Cilt: 47 Sayı: 6, 871 - 877, 26.09.2025
https://doi.org/10.20515/otd.1718272

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.

Kaynakça

  • 1. Suh SW, Modi HN, Yang JH, Hong JY. Idiopathic scoliosis in Korean schoolchildren: a prospective screening study of over 1 million children. Eur Spine J 2011; 20(7): 1087-94.
  • 2. Boylan C, Jones M, Jr DWP, Ellingson AM. Morphological Characteristics of Apical Intervertebral Discs as Predictors of Curve Progression in Adolescents with Idiopathic Scoliosis. Spine J Published online July 8, 2025.
  • 3. Merrill 2017- Merrill RK, Kim JS, Leven DM, Kim JH, Cho SK. Beyond Pelvic Incidence-Lumbar Lordosis Mismatch: The Importance of Assessing the Entire Spine to Achieve Global Sagittal Alignment. Global Spine J. 2017;7(6):536–42.
  • 4. Newton PO, Osborn EJ, Bastrom TP, Doan JD, Reighard FG. The 3D Sagittal Profile of Thoracic Versus Lumbar Major Curves in Adolescent Idiopathic Scoliosis. Spine Deform. 2019;7(1):60–5.
  • 5. Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O'Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018;13:3.
  • 6. Risser JC. The Iliac apophysis; an invaluable sign in the management of scoliosis. Clin Orthop. 1958;11:111-9.
  • 7. Hacquebord JH, Leopold SS. In brief: The Risser classification: a classic tool for the clinician treating adolescent idiopathic scoliosis. Clin Orthop Relat Res. 2012;470(8):2335-8.
  • 8. Coşkun Benlidayı İ, Başaran S, Seydaoğlu G. Lumbosacral morphology in lumbar disc herniation: a "chicken and egg" issue. Acta Orthop Traumatol Turc. 2016;50(3):346-50.
  • 9. Mak T, Cheung PWH, Zhang T, Cheung JPY. Patterns of coronal and sagittal deformities in adolescent idiopathic scoliosis. BMC Musculoskelet Disord. 2021 Jan 8;22(1):44.
  • 10. Zhang C, Wang Y, Yu J, Jin F, Zhang Y, Zhao Y, Fu Y, Zhang K, Wang J, Dai L, Gao M, Li Z, Wang L, Li X, Wang H. Analysis of sagittal curvature and its influencing factors in adolescent idiopathic scoliosis. Medicine (Baltimore). 2021 Jun 11;100(23):e26274.
  • 11. Mac-Thiong JM, Labelle H, Charlebois M, Huot MP, de Guise JA. Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine (Phila Pa 1976). 2003;28(13):1404-9.
  • 12. Schlösser TPC, Castelein RM, Grobost P, Shah SA, Abelin-Genevois K. Specific sagittal alignment patterns are already present in mild adolescent idiopathic scoliosis. Eur Spine J. 2021;30(7):1881-7.
  • 13. Abelin-Genevois K, Sassi D, Verdun S, Roussouly P. Sagittal classification in adolescent idiopathic scoliosis: original description and therapeutic implications. Eur Spine J. 2018;27(9):2192-2202.
  • 14. 1Fruergaard S, Jain MJ, Deveza L, Liu D, Heydemann J, Ohrt-Nissen S, Dragsted C, Gehrchen M, Dahl B; Texas Children’s Hospital Spine Study Group. Evaluation of a new sagittal classification system in adolescent idiopathic scoliosis. Eur Spine J. 2020;29(4):744-53.
  • 15. Coskun Benlidayi I, Tirasci E. The effect of lumbosacral transitional vertebra on lumbar spine degeneration and spondylolisthesis among patients with low back pain. Pain Pract. 2024;24(1):52-61.
  • 16. Bisson DG, Sheng K, Kocabas S, Ocay DD, Ferland CE, Saran N, Ouellet JA, Haglund L. Axial rotation and pain are associated with facet joint osteoarthritis in adolescent idiopathic scoliosis. Osteoarthritis Cartilage. 2023;31(8):1101-10.
  • 17. Boylan C, Thimmaiah R, McKay G, Gardner A, Newton Ede M, Mehta J, Spilsbury J, Marks D, Jones M. Does intervertebral disc degeneration in adolescent idiopathic scoliosis correlate with patient-reported pain scores? A review of 968 cases. Eur Spine J. 2024;33(2):687-94.
  • 18. Ponrartana S, Fisher CL, Aggabao PC, Chavez TA, Broom AM, Wren TA, Skaggs DL, Gilsanz V. Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis. Pediatr Radiol. 2016;46(10):1424-9.
  • 19. Chen H, Schlösser TPC, Brink RC, Colo D, van Stralen M, Shi L, Chu WCW, Heng PA, Castelein RM, Cheng JCY. The Height-Width-Depth Ratios of the Intervertebral Discs and Vertebral Bodies in Adolescent Idiopathic Scoliosis vs Controls in a Chinese Population. Sci Rep. 2017;7:46448.
  • 20. Wang S, Qiu Y, Ma W, Wang B, Yu Y, Qian B, Zhu Z, Zhu F, Sun X. Comparison of disc and vertebral wedging between patients with adolescent idiopathic scoliosis and Chiari malformation-associated scoliosis. J Spinal Disord Tech. 2012;25(5):277-84.
  • 21. Smit TH. Adolescent idiopathic scoliosis: The mechanobiology of differential growth. JOR Spine. 2020;3(4):e1115.
  • 22. Smit TH. On growth and scoliosis. Eur Spine J. 2024;33(6):2439-2450.
  • 23. Modi HN, Suh SW, Song HR, Yang JH, Kim HJ, Modi CH. Differential wedging of vertebral body and intervertebral disc in thoracic and lumbar spine in adolescent idiopathic scoliosis - A cross sectional study in 150 patients. Scoliosis. 2008;3:11.
  • 24. Zhang Q, Chon T, Zhang Y, Baker JS, Gu Y. Finite element analysis of the lumbar spine in adolescent idiopathic scoliosis subjected to different loads. Comput Biol Med. 2021;136:104745.
  • 25. Ding WY, Wu HL, Shen Y, Zhang W, Li BJ, Sun YP, Guo JK, Cao LZ. [Correlation between intervertebral disc-endplate degeneration and bony structural parameter in adult degenerative scoliosis and its significance]. Zhonghua Wai Ke Za Zhi. 2011;49(12):1123-7
  • 26. Foltz MH, Johnson CP, Truong W, Polly DW Jr, Ellingson AM. Morphological alterations of lumbar intervertebral discs in patients with adolescent idiopathic scoliosis. Spine J. 2024;24(1):172-184.
  • 27. Yeung KH, Man GCW, Deng M, Lam TP, Cheng JCY, Chan KC, Chu WCW. Morphological changes of Intervertebral Disc detectable by T2-weighted MRI and its correlation with curve severity in Adolescent Idiopathic Scoliosis. BMC Musculoskelet Disord. 2022;23(1):655.

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

Yıl 2025, Cilt: 47 Sayı: 6, 871 - 877, 26.09.2025
https://doi.org/10.20515/otd.1718272

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

Kaynakça

  • 1. Suh SW, Modi HN, Yang JH, Hong JY. Idiopathic scoliosis in Korean schoolchildren: a prospective screening study of over 1 million children. Eur Spine J 2011; 20(7): 1087-94.
  • 2. Boylan C, Jones M, Jr DWP, Ellingson AM. Morphological Characteristics of Apical Intervertebral Discs as Predictors of Curve Progression in Adolescents with Idiopathic Scoliosis. Spine J Published online July 8, 2025.
  • 3. Merrill 2017- Merrill RK, Kim JS, Leven DM, Kim JH, Cho SK. Beyond Pelvic Incidence-Lumbar Lordosis Mismatch: The Importance of Assessing the Entire Spine to Achieve Global Sagittal Alignment. Global Spine J. 2017;7(6):536–42.
  • 4. Newton PO, Osborn EJ, Bastrom TP, Doan JD, Reighard FG. The 3D Sagittal Profile of Thoracic Versus Lumbar Major Curves in Adolescent Idiopathic Scoliosis. Spine Deform. 2019;7(1):60–5.
  • 5. Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O'Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018;13:3.
  • 6. Risser JC. The Iliac apophysis; an invaluable sign in the management of scoliosis. Clin Orthop. 1958;11:111-9.
  • 7. Hacquebord JH, Leopold SS. In brief: The Risser classification: a classic tool for the clinician treating adolescent idiopathic scoliosis. Clin Orthop Relat Res. 2012;470(8):2335-8.
  • 8. Coşkun Benlidayı İ, Başaran S, Seydaoğlu G. Lumbosacral morphology in lumbar disc herniation: a "chicken and egg" issue. Acta Orthop Traumatol Turc. 2016;50(3):346-50.
  • 9. Mak T, Cheung PWH, Zhang T, Cheung JPY. Patterns of coronal and sagittal deformities in adolescent idiopathic scoliosis. BMC Musculoskelet Disord. 2021 Jan 8;22(1):44.
  • 10. Zhang C, Wang Y, Yu J, Jin F, Zhang Y, Zhao Y, Fu Y, Zhang K, Wang J, Dai L, Gao M, Li Z, Wang L, Li X, Wang H. Analysis of sagittal curvature and its influencing factors in adolescent idiopathic scoliosis. Medicine (Baltimore). 2021 Jun 11;100(23):e26274.
  • 11. Mac-Thiong JM, Labelle H, Charlebois M, Huot MP, de Guise JA. Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine (Phila Pa 1976). 2003;28(13):1404-9.
  • 12. Schlösser TPC, Castelein RM, Grobost P, Shah SA, Abelin-Genevois K. Specific sagittal alignment patterns are already present in mild adolescent idiopathic scoliosis. Eur Spine J. 2021;30(7):1881-7.
  • 13. Abelin-Genevois K, Sassi D, Verdun S, Roussouly P. Sagittal classification in adolescent idiopathic scoliosis: original description and therapeutic implications. Eur Spine J. 2018;27(9):2192-2202.
  • 14. 1Fruergaard S, Jain MJ, Deveza L, Liu D, Heydemann J, Ohrt-Nissen S, Dragsted C, Gehrchen M, Dahl B; Texas Children’s Hospital Spine Study Group. Evaluation of a new sagittal classification system in adolescent idiopathic scoliosis. Eur Spine J. 2020;29(4):744-53.
  • 15. Coskun Benlidayi I, Tirasci E. The effect of lumbosacral transitional vertebra on lumbar spine degeneration and spondylolisthesis among patients with low back pain. Pain Pract. 2024;24(1):52-61.
  • 16. Bisson DG, Sheng K, Kocabas S, Ocay DD, Ferland CE, Saran N, Ouellet JA, Haglund L. Axial rotation and pain are associated with facet joint osteoarthritis in adolescent idiopathic scoliosis. Osteoarthritis Cartilage. 2023;31(8):1101-10.
  • 17. Boylan C, Thimmaiah R, McKay G, Gardner A, Newton Ede M, Mehta J, Spilsbury J, Marks D, Jones M. Does intervertebral disc degeneration in adolescent idiopathic scoliosis correlate with patient-reported pain scores? A review of 968 cases. Eur Spine J. 2024;33(2):687-94.
  • 18. Ponrartana S, Fisher CL, Aggabao PC, Chavez TA, Broom AM, Wren TA, Skaggs DL, Gilsanz V. Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis. Pediatr Radiol. 2016;46(10):1424-9.
  • 19. Chen H, Schlösser TPC, Brink RC, Colo D, van Stralen M, Shi L, Chu WCW, Heng PA, Castelein RM, Cheng JCY. The Height-Width-Depth Ratios of the Intervertebral Discs and Vertebral Bodies in Adolescent Idiopathic Scoliosis vs Controls in a Chinese Population. Sci Rep. 2017;7:46448.
  • 20. Wang S, Qiu Y, Ma W, Wang B, Yu Y, Qian B, Zhu Z, Zhu F, Sun X. Comparison of disc and vertebral wedging between patients with adolescent idiopathic scoliosis and Chiari malformation-associated scoliosis. J Spinal Disord Tech. 2012;25(5):277-84.
  • 21. Smit TH. Adolescent idiopathic scoliosis: The mechanobiology of differential growth. JOR Spine. 2020;3(4):e1115.
  • 22. Smit TH. On growth and scoliosis. Eur Spine J. 2024;33(6):2439-2450.
  • 23. Modi HN, Suh SW, Song HR, Yang JH, Kim HJ, Modi CH. Differential wedging of vertebral body and intervertebral disc in thoracic and lumbar spine in adolescent idiopathic scoliosis - A cross sectional study in 150 patients. Scoliosis. 2008;3:11.
  • 24. Zhang Q, Chon T, Zhang Y, Baker JS, Gu Y. Finite element analysis of the lumbar spine in adolescent idiopathic scoliosis subjected to different loads. Comput Biol Med. 2021;136:104745.
  • 25. Ding WY, Wu HL, Shen Y, Zhang W, Li BJ, Sun YP, Guo JK, Cao LZ. [Correlation between intervertebral disc-endplate degeneration and bony structural parameter in adult degenerative scoliosis and its significance]. Zhonghua Wai Ke Za Zhi. 2011;49(12):1123-7
  • 26. Foltz MH, Johnson CP, Truong W, Polly DW Jr, Ellingson AM. Morphological alterations of lumbar intervertebral discs in patients with adolescent idiopathic scoliosis. Spine J. 2024;24(1):172-184.
  • 27. Yeung KH, Man GCW, Deng M, Lam TP, Cheng JCY, Chan KC, Chu WCW. Morphological changes of Intervertebral Disc detectable by T2-weighted MRI and its correlation with curve severity in Adolescent Idiopathic Scoliosis. BMC Musculoskelet Disord. 2022;23(1):655.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ağrı, Toplum Çocuk Sağlığı, Fiziksel Tıp ve Rehabilitasyon
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

İlke Coşkun Benlidayı 0000-0001-6517-5969

Aylin Sarıyıldız 0000-0002-8835-4203

Burak Demir 0000-0003-0818-0491

Kübra Tuncer 0009-0006-8677-7655

Yayımlanma Tarihi 26 Eylül 2025
Gönderilme Tarihi 12 Haziran 2025
Kabul Tarihi 28 Temmuz 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 6

Kaynak Göster

Vancouver Coşkun Benlidayı İ, Sarıyıldız A, Demir B, Tuncer K. Analysis of Lumbosacral Sagittal Spinal Alignment in Adolescent Idiopathic Scoliosis: A 10-Year Retrospective Data Review. Osmangazi Tıp Dergisi. 2025;47(6):871-7.


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