Degenerative lumbar scoliosis (DLS) is a common spinal deformity in older adults. This study, for the first time, investigates the biomechanical role of the first coronal reverse vertebra (FCRV) in DLS progression using a patient-specific finite element (FE) model.
The high-fidelity FE model, based on a patient's CT data, simulated spinal loading during standing, lateral bending, and axial rotation. Analysis revealed that FCRV acts as a mechanical pivot. During neutral standing, the most frequent daily posture, the intervertebral disc directly below the FCRV (the lower disc, LD) sustained the highest level of continuous stress. Although axial rotation generated greater peak stress, the prolonged stress on the LD during standing is the key factor that predisposes it to accelerated degeneration. Furthermore, the stress demonstrated local concentration, particularly on the concave side of the scoliosis.
FCRV represents the transitional point of the mechanical load on the coronal plane, which caused the LD to take on greater stress magnitudes, notably under the NS. The stress exhibited local concentration, especially on the concave side of the scoliosis. These findings could contribute to further treatment planning for the patient by providing computer-aided assessments to aid physicians’ management decision-making.
The work titled “Biomechanical characteristics of first coronal reverse vertebrae in degenerative lumbar scoliosis: A study using finite element analysis”, was published on Spine Research (accepted on Jun. 18, 2025).
DOI: 10.1097/br9.0000000000000007