Are There Changes in Sagittal Alignment of Cervical Spine after Posterior Spinal Instrumentation in Adolescent Idiopathic Scoliosis?
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AbstractIntroduction: The importance of sagittal alignment in thoracic and lumbar spine have been well documented. The
alignment of cervical spine in sagittal plane in adolescent idiopathic scoliosis (AIS) with different curve types was unclear. This study aimed to analyse the changes of cervical alignment following posterior instrumentation in AIS with different curve patterns.

Methods: Radiographic data were retrospectively reviewed in 51 thoracic-AIS (T-AIS; mean [± standard deviation] age
48.19 ± 7.0 years, range 41-72 years) and 50 lumbar-AIS (L-AIS; 46.31 ± 5.39 years, range 40-66 years) patients with a minimum of 2-year postoperative follow-up. All pedicle screws were used in these patients and T-AIS patients had a
longer fusion level (10.70 vs. 7.69). Radiographic parameters analysed included cervical sagittal parameters (cervical
lordosis [CL], T1 slope [TS], TS-CL, T1-Spi [angle between T1-hip axis and vertical], TPA [T1 pelvic angle], and C2-C7 SVA [sagittal vertical axis]) and spinopelvic sagittal parameters. Paired t tests were used for comparison with 0.05 as statistical significant threshold.

Results: No significant differences in the mean age or follow-up time were observed. At baseline, larger CL (5.69 vs. -5.11, p=0.002) and smaller TS-CL (9.26 vs. 17.09, p=0.001) was noted in L-AIS patients, while preoperative thoracic kyphosis (TK) showed no difference. When the immediate postoperative sagittal profiles were compared, larger TK (23.72 vs. 18.86, p=0.009) and more obvious CL (7.26 vs. -2.60, p=0.001) were noticed in L-AIS group. During the follow-up, larger TK and CL were maintained in L-AIS group. Significant correlation was found between the improvement of CL and TK restoration in L-AIS patients (r= –0.473, p=0.002).

Conclusion: Correlations between the improvement of CL and TK highlighted the importance of restoration of normal TK in AIS patients. Due to these reciprocal changes, hypokyphosis may be responsible for loss of CL in AIS patients which may impact the posture or even function of cervical spine.
All Author(s) ListF. Zhu, P. Yan, T. P. Lam, J. C. Y. Cheng, B. K. W. Ng and Y. Qiu
Name of ConferenceThe 36th Annual Congress of the Hong Kong Orthopaedic Association (HKOA)
Start Date of Conference05/11/2016
End Date of Conference06/11/2016
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
LanguagesEnglish-United Kingdom

Last updated on 2018-22-01 at 09:16