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. 2021 Dec 14;6(3):247-251.
doi: 10.22603/ssrr.2021-0176. eCollection 2022.

Risk Factors for Lateral Translation in Residual Adolescent Idiopathic Scoliosis with a Thoracolumbar/Lumbar Curve

Toshiaki Kotani  1 , Tsuyoshi Sakuma  1 , Yasushi Iijima  1 , Yasuchika Aoki  2 , Kotaro Sakashita  1 , Kohei Okuyama  1 , Takahiro Sunami  3 , Kosuke Sato  3 , Tomoyuki Asada  3 , Tsutomu Akazawa  4 , Kazuhide Inage  5 , Yasuhiro Shiga  5 , Takashi Hozumi  5 , Shohei Minami  1 , Seiji Ohtori  5
Affiliations

Risk Factors for Lateral Translation in Residual Adolescent Idiopathic Scoliosis with a Thoracolumbar/Lumbar Curve

Toshiaki Kotani et al. Spine Surg Relat Res. .

Abstract

Introduction: Although lateral vertebral translation is associated with inducing curve progression and pain, no study has analyzed risk factors for lateral slip in patients with residual adolescent idiopathic scoliosis (AIS). This study aimed to investigate risk factors for lateral slip in patients with residual AIS.

Methods: We included 42 preoperative patients with residual AIS with a thoracolumbar/lumbar (TL/L) curve (3 male, 39 female; age 41.9±18.2 years, TL/L Cobb angle 55.5±10.0°). All patients were >20 years and had been diagnosed with AIS during their adolescence. Lateral slip was defined as more than a 6-mm slip on coronal CT images.

Results: Patients were divided into slip (n=22) and nonslip (n=20) groups. Significant differences were observed in age, TL/L Cobb angle, TL/L curve flexibility, lumbar lordosis, thoracolumbar kyphosis, apical vertebral rotation, apical vertebral translation, and L3 and L4 tilt between the groups. Multivariate analyses and receiver operating characteristic curves found that only older age was a significant risk factor for lateral slip (odds ratio: 1.214; 95% confidence interval: 1.047-1.407; P=0.010), with a cutoff value of 37 years old.

Conclusions: Older age, especially >37 years, is a risk factor for lateral slip in patients with residual AIS. These findings suggest that surgery for residual AIS should be considered before patients are in their mid-30s to avoid lateral translation.

Keywords: adolescent idiopathic scoliosis; lateral translation; surgery.

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Conflict of interest statement

Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.
Examples of cases of residual AIS in a 20-year-old woman (a) and a 79-year-old woman (b). Coronal CT imaging showing lateral slip between L3 and L4 in the 79-year-old woman (indicated by arrows), although both patients had similar degrees of thoracolumbar curvature.
Figure 2.
Figure 2.
Distribution of lateral slip by level. Lateral translation was most frequent in L3–L4, followed by L4–L5.
Figure 3.
Figure 3.
Receiver operating characteristic curve indicating the cutoff value for age-associated lateral translation in patients with residual AIS. The cutoff value was 37 years old.
See this image and copyright information in PMC

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