Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients

BMC Musculoskeletal Disorders

Fengliang Wu¹  Feng Wei¹  Junyu Li¹  Yongqiang Wang¹  Xiaoguang Liu¹  Yan Li¹  Yanchao Tang¹  Zexi Yang¹  Miao Yu¹  Zhongjun Liu¹  Weishi Li¹  Hua Zhou¹  Kaige Deng² 

[1] Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, China;Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, 100191, Beijing, China;Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, 100191, Beijing, China;Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, 100191, Beijing, China;

关键词: Adolescent idiopathic scoliosis;    pedicle screws;    cervical sagittal compensation;    cervical kyphosis;    independent risk factors;   

DOI  :  10.1186/s12891-021-04884-4

来源: Springer

【 摘 要 】

BackgroundThis study aims to analyze postoperative changes of cervical sagittal curvature and to identify independent risk factors for cervical kyphosis in Lenke type 1 adolescent idiopathic scoliosis (AIS) patients.MethodsA total of 124 AIS patients who received all-pedicle-screw instrumentation were enrolled. All patients were followed up for at least 2 years. The following parameters were measured preoperatively, immediately after the operation, and at the last follow-up: pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), global thoracic kyphosis (GTK), proximal thoracic kyphosis (PrTK), T1-slope, cervical lordosis (CL), McGregor slope (McGS), sagittal vertical axis (SVA), C2–7 SVA (cSVA), and main thoracic angle (MTA). Statistical analysis was performed to evaluate postoperative alterations of and correlations between the parameters and to identify risk factors for cervical kyphosis. Statistical significance was set at P < 0.05.ResultsAfter the operation, PrTK and T1-slope significantly increased (3.01 ± 11.46, 3.8 ± 10.76, respectively), cervical lordosis improved with an insignificant increase (− 2.11 ± 13.47, P = 0.154), and MTA, SS, and LL decreased significantly (− 33.68 ± 15.35, − 2.98 ± 8.41, 2.82 ± 9.92, respectively). Intergroup comparison and logistic regression revealed that preoperative CK > 2.35° and immediate postoperative GTK < 27.15° were independent risk factors for final cervical kyphosis, and △T1-slope < 4.8° for a kyphotic trend.ConclusionsPostoperative restoration of thoracic kyphosis, especially proximal thoracic kyphosis, and T1-slope play a central role in cervical sagittal compensation. Preoperative CK, postoperative small GTK, and insufficient △T1-slope are all independent risk factors for cervical decompensation.

【 授权许可】

CC BY