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Adult Scoliosis: Prevalence, SF-36, and Nutritional Parameters in an Elderly Volunteer Population

Schwab, Frank MD*; Dubey, Ashok MD*; Gamez, Lorenzo MD*; El Fegoun, Abdelkrim Benchikh MD†; Hwang, Ki MD*; Pagala, Murali PhD‡; Farcy, J -P. MD*

doi: 10.1097/
Health Services Research

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 ≥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 was17° in the frontal plane. In the study group, 68% of subjects met the definition of scoliosis (Cobb angle >10°). 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.

In Brief

This study analyzed the prevalence of adult scoliosis in a volunteer, healthy elderly (older than 60 years) population (75 subjects). Radiographic studies, nutritional laboratory profiles, and the RAND 36-Item Health Surveys were analyzed. The prevalence of adult scoliosis was higher than previously reported (68%). No correlations existed among adult scoliosis and visual analog scale scores, or nutritional status in this healthy, elderly volunteer population. In one subgroup (group II) alone, 3 of the 8 RAND 36-Item Health Survey categories were significantly different from the United States population benchmark data (age 65–74 years).

Author Information

From the *Department of Orthopaedic Surgery, Spine Service, Maimonides Medical Center, Brooklyn, NY; †Orthopaedic Surgery, CHU Nice, France; and ‡Surgical Research, Maimonides Medical Center, Brooklyn, NY.

Acknowledgment date: August 11, 2003. First revision date: October 27, 2003. Second revision date: February 14, 2004. Third revision date: May 22, 2004. Fourth revision date: June 12, 2004. Acceptance date: June 16, 2004.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Corporate/Industry and Institutional funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Frank Schwab, MD, 927 49th Street, Brooklyn, NY 11219; E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.