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Open Access 01-12-2021 | Scoliosis | Research

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

Authors: Junyu Li, Kaige Deng, Yanchao Tang, Zexi Yang, Xiaoguang Liu, Zhongjun Liu, Feng Wei, Fengliang Wu, Hua Zhou, Yan Li, Yongqiang Wang, Weishi Li, Miao Yu

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

This 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.

Methods

A 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.

Results

After 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.

Conclusions

Postoperative 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.

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Title: Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients
Authors: Junyu Li
Kaige Deng
Yanchao Tang
Zexi Yang
Xiaoguang Liu
Zhongjun Liu
Feng Wei
Fengliang Wu
Hua Zhou
Yan Li
Yongqiang Wang
Weishi Li
Miao Yu
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Scoliosis
Adolescent Idiopathic Scoliosis
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04884-4

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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