Author(s): Schwab F, Dubey A, Gamez L, El Fegoun AB, Hwang K,
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Abstract STUDY DESIGN: A prospective self-assessment analysis and evaluation of nutritional and radiographic parameters in a consecutive series of healthy adult volunteers older than 60 years. OBJECTIVES: To ascertain the prevalence of adult scoliosis, assess radiographic parameters, and determine if there is a correlation with functional self-assessment in an aged volunteer population. SUMMARY OF BACKGROUND DATA: There exists little data studying the prevalence of scoliosis in a volunteer aged population, and correlation between deformity and self-assessment parameters. METHODS: There were 75 subjects in the study. Inclusion criteria were: age > or =60 years, no known history of scoliosis, and no prior spine surgery. Each subject answered a RAND 36-Item Health Survey questionnaire, a full-length anteroposterior standing radiographic assessment of the spine was obtained, and nutritional parameters were analyzed from blood samples. For each subject, radiographic, laboratory, and clinical data were evaluated. The study population was divided into 3 groups based on frontal plane Cobb angulation of the spine. Comparison of the RAND 36-Item Health Surveys data among groups of the volunteer population and with United States population benchmark data (age 65-74 years) was undertaken using an unpaired t test. Any correlation between radiographic, laboratory, and self-assessment data were also investigated. RESULTS: The mean age of the patients in this study was 70.5 years (range 60-90). Mean Cobb angle was 17 degrees in the frontal plane. In the study group, 68\% of subjects met the definition of scoliosis (Cobb angle >10 degrees). No significant correlation was noted among radiographic parameters and visual analog scale scores, albumin, lymphocytes, or transferrin levels in the study group as a whole. Prevalence of scoliosis was not significantly different between males and females (P > 0.03). The scoliosis prevalence rate of 68\% found in this study reveals a rate significantly higher than reported in other studies. These findings most likely reflect the targeted selection of an elderly group. Although many patients with adult scoliosis have pain and dysfunction, there appears to be a large group (such as the volunteers in this study) that has no marked physical or social impairment. CONCLUSIONS: Previous reports note a prevalence of adult scoliosis up to 32\%. In this study, results indicate a scoliosis rate of 68\% in a healthy adult population, with an average age of 70.5 years. This study found no significant correlations between adult scoliosis and visual analog scale scores or nutritional status in healthy, elderly volunteers.
This article was published in Spine (Phila Pa 1976)
and referenced in Journal of Pain & Relief