Analysis of Lumbosacral Sagittal Spinal Alignment in Adolescent Idiopathic Scoliosis: A 10-Year Retrospective Data Review

This study aimed to investigate lumbosacral sagittal alignment in patients with adolescent idiopathic scoliosis (AIS). The study included data of patients with AIS aged 10-18 years from a ten-year period (between January 2013 and January 2023). Using digitized radiographies, sagittal and coronal spinal parameters including Cobb angle, Risser staging, intervertebral disc angles, lumbar lordosis angle, lumbosacral lordosis angle, lumbosacral angle, sacral tilt and disc heights were measured and analyzed. Patients were categorized based on the Cobb angle into high (≥23.8°) and low (<23.8°) angle groups. Results: A total of 1102 scoliosis x-rays have been evaluated for eligibility. Of those, 122 patients (73% female) were included in the analyses. The median age and Cobb angle were 14 (4) years and 23.8 (13.9) degrees, respectively. Majority of the patients (43.4%) had thoracic curvature. The most frequently observed Risser grade was 4 (n=48). Patients with a Cobb angle ≥23.8° exhibited significantly lower L5-S1 intervertebral disc heights when compared to those with a Cobb angle <23.8° (p=0.014). No significant differences were observed in other sagittal parameters between high and low Cobb angle groups. In patients with AIS, those with high Cobb angle have lower L5-S1 intervertebral disc heights compared to the low Cobb angle group. Since reduced disc height may serve as an early indicator of potential disc degeneration or herniation, high-angle AIS patients would require closer monitoring. The study emphasizes the importance of early assessment to prevent future musculoskeletal risks in AIS patients with higher curvature angles