Are there Changes in sagittal alignment of Cervical Spine after posterior spinal instrumentation in Adolescent Idiopathic Scoliosis?
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AbstractIntroduction:
Sagittal alignment in thoracic and lumbar spine and its vital association with quality of life have been well documented. While the compensation of cervical spine on sagittal plain in AIS patients with different curve types remains unclear. This study aims to analyze postoperative changes of cervical alignment in AIS patients with different curve patterns.

Methods:
Radiographic data were retrospectively reviewed in 51 AIS patients with right thoracic major curve Vs 50 with major lumbar curve with a minimum of 2-year follow-up. Radiographic parameters analyzed in this study including cervical sagittal parameters (cervical lordosis (CL), T1 slope, TS-CL, T1-Spi, TPA and C2-C7 SVA) and spinopelvic sagittal parameters (PI, PT, SS, TK, LL, C7-S1 SVA, PI-LL) obtained from standardized full length standing PA and Lateral radiographs . Paired t tests were used for comparison with 0.05 as statistical significant threshold.

Results:
No significant differences in the mean age and follow up time were observed between thoracic and lumbar AIS groups. At baseline, larger cervical lordosis (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 pre-op TK showed no difference between two groups. When the immediate post-op sagittal profiles were compared between two groups, larger TK (23.72° VS. 18.86°, p=0.009) and more obvious cervical lordosis (7.26° VS -2.60°, p=0.001) were noticed in L AIS group. During the follow up, larger TK and CL were still maintained in L-AIS group. In addition, a 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 cervical lordosis and thoracic kyphosis highlighted the importance of restoration of normal TK in AIS patient. Due to this reciprocal changes hypokyphosis of thoracic spine may be responsible for loss of cervical lordosis or even cervical kyphosis in AIS patients which may impact the posture or even function of cervical spine in future.
All Author(s) ListF. Zhu, P. Yan, H. Bao, S. Liu, T. P. Lam, J. C. Y. Cheng, B. K. W. Ng, Y. Qiu
Name of Conference11th International Congress of Chinese Orthopaedic Association (COA)
Start Date of Conference17/11/2016
End Date of Conference20/11/2016
Place of ConferenceBeijing, China
Country/Region of ConferenceChina
Year2016
LanguagesEnglish-United Kingdom
KeywordsAIS, Sagittal alignment

Last updated on 2018-22-01 at 09:17