Thoracic scoliosis prevalence in patients 50 years or older and its relationship with age, sex, and thoracic kyphosis

Abstract

Study design: Cross-sectional study.

Objective: To determine the prevalence of thoracic scoliosis in patients aged 50 years or older and to investigate the association of adult thoracic scoliosis with age, sex, and thoracic sagittal curve.

Summary of background data: The prevalence of adult thoracic scoliosis has not been clearly determined. In addition, limited data are available on the correlation of adult thoracic scoliosis to age, sex, and thoracic kyphosis.

Methods: We studied 760 patients aged 50 years or older (380 males and 380 females) who were evaluated using standing chest plain radiographs. The thoracic curvatures in the coronal and sagittal planes were measured using the Cobb method. Scoliosis was defined by the presence of a coronal curvature 10° or more. We performed a correlation analysis of the coronal curve with age and sagittal curve; in addition, a linear regression analysis was carried out to evaluate age, sex, and sagittal curve as independent predictors of the coronal Cobb angle of the thoracic spine.

Results: The prevalence of thoracic scoliosis was 24.2% (184 cases); 160 patients (21.1%) had curves 10° or more but less than 20°; 20 patients (2.6%) had curves 20° or more but less than 30°; and 4 patients (0.5%) had curves 30° or more. Females exhibited a higher prevalence of scoliosis (28.9%) than did males (19.4%), P < 0.01. The older patients exhibited increased scoliosis, but no differences were observed in thoracic kyphosis with increasing scoliosis. Age and sex were independent predictors of the coronal Cobb angle; however, the sagittal angle was not.

Conclusion: We found a 24.2% prevalence of thoracic scoliosis in patients 50 years or older; most curves were less than 20°. Thoracic scoliosis was more common in females and in older patients.

Level of evidence: 3.