抄録
The natural history of degenerative lumbar scoliosis is still obscure. In order to clarify the risk factors of the curve progression of lumbar scoliosis, the relationship of the initial radiological findings and the curve progression was investigated. A review was conducted on the radiographs of 575 adult patients over 40 years old with low back pain who visited Kochi Medical School hospital in 1994. Out of them, 153 (26%) proved to have degenerative lumbar scoliosis of more than 5 degrees. The natural history of the curve progression was investigated in the 53 patients who were followed for more than 1 year. The age of the patients ranged from 41 to 83 years old. The mean follow up period was 7 years and 5 months.
Radiological investigation demonstrated that the curve progression did not relate to the initial magnitude of the curve, sex, age, the covexity of the curve, the degree of osteoporosis and antero-posterior vertebral slippage on the X-ray taken at the initial visit. It was found that the risk factors of the curve progression are vertebral rotation and L4 vertebral tilt to the pelvis. The appearance of body spur formation of the vertebrae was thought to signal suppression of the curve progression. Further investigation with a larger number of patients and longer follow up duration is necessary to identify more precisely the risk factors of the curve progression.
