Changes in Global Sagittal Alignment after Posterior Instrumentation of Right Thoracic Curve in Adolescent Idiopathic Scoliosis with and without Thoracic Hypokyphosis
Refereed conference paper presented and published in conference proceedings


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AbstractIntroduction: Patients with adolescent idiopathic scoliosis (AIS) with thoracic curve often present with rotatory deformity and diminution of thoracic kyphosis. However, the change of global sagittal alignment (GSA) during thoracic kyphosis restoration remains uncertain. The aims of this study were to evaluate these changes in AIS with and without thoracic hypokyphosis during surgical correction, in comparison with healthy controls.
Methods: The patients with AIS were subdivided into thoracic hypokyphosis (THK) and normal thoracic kyphosis (NTK). Early-onset scoliosis radiographies were acquired at baseline, immediately after surgery, and at 1-year and 2-year followup examination. Multiple GSA parameters and head positions were measured, including ratio of sagittal vertical axis to sacrofemoral distance (SVA/SFD), and angle of odontoid–hip axis (OD-HA) line.
Results: Twenty-four operative AIS girls with right thoracic curvature and 36 female asymptomatic controls (NC) were recruited. There were significant differences on multiple GSA parameters between patients with AIS, with and without THK, and NC. Compared with NC, patients with AIS with THK at baseline had higher SVA/SFD (p<0.05) and OD-HA (p<0.05), indicating that THK had compensated balance with unusual forward leaning posture. Immediately after surgery, SVA/SFD still remained high while OD-HA reversed, suggesting balance remained partially compensated. Both parameters were normalised after 2 years, indicating sagittal balance finally achieved. In contrast, no significant difference was found between NTK and NC. Changes in GSA and mechanism of balance are different in patients with AIS with or without THK.
Conclusion: As the head plays a critical role on balance during immediate and delayed after surgery, OD-HA can be complementary parameter for assessing global balance during follow-up of patients with AIS with THK.
Acceptance Date02/10/2019
All Author(s) ListKH Yeung, GCW Man, C Vergari, W Skalli, JCY Cheng, WCW Chu
Name of ConferenceHong Kong Orthopaedic Association 39th Annual Congress 2019 (HKOA 2019)
Start Date of Conference02/11/2019
End Date of Conference03/11/2019
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Year2019
Month11
Day2
Place of PublicationHong Kong
LanguagesEnglish-United Kingdom

Last updated on 2020-29-05 at 11:44