Scoliosis is a Risk Factor for Gastroesophageal Reflux Disease in Adult Spinal Deformity

Study Design: A prospective observational study.

Objective: To evaluate whether scoliosis is a risk factor for gastroesophageal reflux disease (GERD) in elderly patients.

Summary Of Background Data: Sagittal spinal deformities are reported to cause GERD, but its association with spinal deformity in the coronal plane is not well studied.

Methods: We examined 190 patients with spinal disorders (mean age 70.6±8.6 y) who underwent standing whole-spine x-rays in the coronal and sagittal planes. GERD symptoms were assessed by Quest score, with a cutoff of 6 points. The relationship between GERD symptoms and radiographic parameters was evaluated. Right convex coronal curves were given negative values, and left convex curves positive values. Degenerative scoliosis was defined when the thoracolumbar/lumbar Cobb angle had an absolute value >10 degrees. Risk factors for GERD were evaluated with univariate and multivariate logistic regression analyses.

Results: Of the patients, 126 had degenerative scoliosis at the thoracolumbar/lumbar spine (42 with right and 84 with left convex curve), and 59 had GERD. Multivariate logistic regression analysis revealed that the lumbar Cobb angle was significantly associated with GERD (P<0.05, odds ratio=1.021). When patients were categorized by Cobb angle of the lumbar curve (<-30 degrees, large right convex curve; -30 to +30 degrees, small curve; or >+30 degrees, large left convex curve), a large left convex curve was strongly associated with GERD (P<0.05, odds ratio=10.925).

Conclusions: Left thoracolumbar/lumbar curve was a significant risk factor for GERD, and risk increased with a curve >30 degrees. Organ disorders such as GERD should be considered when treating elderly patients with degenerative scoliosis.