The study of the factors causing lumbar rotatory scoliosis with anatomical parameters

Objective: Degenerative lumbar rotatory scoliosis is a health problem which seriously affects the quality of life in elderly people. In our study, we evaluated the radiographs of the lumbar spine and lumbar MRI scans of patients who applied to Akdeniz University Hospital Neurosurgery Clinic between the dates of 1st January of 2014 and 20th April of 2019 with the parameters that we have defined and we aimed to determine the preventable factors related to abnormal anatomic values and findings and to avoid progression of scoliosis. Materials and Methods: Twenty patients with severe rotational scoliosis were included in the study. There are 15 patients with normal lumbar region anatomy in the control group. We have made a comparison with measurements of several MRI scans that we have defined between the patients with advanced scoliosis in radiographs of the lumbar spine and control group. These parameters are: Psoas muscle cross-sectional area (CSA), paraspinal muscle cross-sectional area (CSA), disc asymmetry measurement, facet joint angle, facet joint cross-sectional area (CSA), processus spinosus/corpus vertebrae rotation difference, facet joint/corpus vertebrae distance measure. We have measured that cross-sectional areas as square millimeters, distance measures as millimeters and angles as degree. The repeated and controlled measurements have been done with SECTRA PACS program through the archive system of our hospital. The data analysis is presented with descriptive statistics, frequency, percentage, mean and standard deviation. An independent t test analysis has been used in patients and control group and paired t test analysis for examination of measurements according to the directions. In this study, p-value less than 0.05 was considered as statistically significant. Analysis are conducted with SPSS 22.0 package program. Results: It has been shown that psoas muscle CSAs, facet joint CSAs, facet joint angles, facet joint/corpus vertebrae distance measures have significantly lower values than the contralateral side in lumbar MRI scans of patients with scoliosis. It has been observed that the lumbar disc heights in the side of scoliosis have higher values than the contralateral side. There was no significant difference in paraspinal muscle CSA measurements in the comparison of both sides determined. Conclusion: In our study, we consider that scoliosis can be prevented with physical therapy exercise programs and conservative precautions for abnormal anatomical structures which we determined. We believe that prospective studies will be available in degenerative lumbar scoliosis patients in order to better demonstrate the relationship between etiological factors and scoliosis. We believe that prospective studies will be helpful to better demonstrate the relationship between etiological factors and scoliosis in degenerative lumbar scoliosis patients.