Prevalence and Factors Affecting Cervical Deformity in Adolescent Idiopathic Scoliosis Patients: A Single-Center Retrospective Radiological Study

Sagittal morphology of the cervical spine in adolescent idiopathic scoliosis: a retrospective case-control study

BACKGROUND

To investigate the relationship between sagittal alignment and coronal deformity in patients with adolescent idiopathic scoliosis (AIS) through analysis of the spinal imaging data.

METHODS

Four hundred and fifty-four AIS patients who underwent anteroposterior and lateral radiography of the while spine were enrolled, and the spinal parameters of Cobb angle, cervical lordosis, C1-C2 angle, T1 slope, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt (PT), pelvic incidence (PI), cervical sagittal vertical axis (SVA), and spinal SVA were analyzed.

RESULTS

The patients were divided into two groups according to the size of the Cobb angle: group A (Cobb angle ≤45°, n=414) and group B (Cobb angle >45°, n=40). In group A, the Cobb angle was in a medium negative correlation with the cervical lordosis angle (r=-0.637, P<0.001), a weak positive correlation (|r|<0.3, P<0.05) with C1-C2 angle, T1 slope and thoracic kyphosis. In group B, the Cobb angle was in a mild positive correlation (P<0.05) with PT (r=0.398) and PI (r=0.360). The cervical lordosis angle was significantly (P<0.05) different between male and female patients in both groups. In Group A, the cervical lordosis angle was in a significantly (P<0.01) positive correlation with the T1 slope (r=0.586), thoracic kyphosis (r=0.490), and sagittal vertical axis (r=0.135), and a significantly (P<0.01) negative correlation with cervical sagittal vertical axis (r=-0.128) and C1-C2 angle (r=-0.155). In group B, the cervical lordosis angle was in a significantly (P<0.05) positive correlation with T1 slope (r=0.661), thoracic kyphosis (r=0.608), lumbar lordosis (r=0.425), sacral slope (r=0.434), and sagittal vertical axis (r=0.335).

CONCLUSIONS

In AIS patients with the Cobb angle ≤45º, a significant negative correlation exists between the cervical lordosis and the Cobb angle. The sagittal morphology of the cervical spine in AIS patients is affected by the spinal coronal deformity, which plays an important role in the treatment of AIS.

Cervical kyphosis in asymptomatic populations: incidence, risk factors, and its relationship with health-related quality of life

Background

Cervical kyphosis has been pointed out in asymptomatic populations. The purposes of this study were (1) to investigate the incidence of cervical kyphosis in asymptomatic populations, (2) to identify risk factors related to cervical kyphosis, and (3) to assess the relationship between cervical kyphosis and health-related quality of life (HRQOL).

Methods

A cohort of 235 asymptomatic volunteers’ records was retrospectively analyzed. Radiographic parameters of the coronal and sagittal planes were measured in the full-length spine x-ray. All patients were classified into two groups based on the cervical lordosis angle: cervical lordosis (CL) and cervical kyphosis (CK). HRQOL was evaluated by EQ-5D and SF-36 (PCS and MCS) questionnaires.

Results

CK was observed in 90 of 235 (38.3%) participants. There was a significant difference with regard to age between volunteers with CK and CL (32.23 ± 8.12 vs. 42.12 ± 6.14, p < 0.05). Several parameters had a significant relationship with CK, including TK, T1 slope, TIA, SVA, and CT. Logistic regression analysis identified age, TK, T1 slope, and SVA as independent risk factors of CK. In addition, there was a negative correlation between CK and the parameters of HRQOL (EQ-5D, − 0.63; PCS, − 0.68; MCS, − 0.59).

Conclusions

The incidence of CK in normal populations is 38.3%. Some spinal parameters are related to CK. CK is associated with the HRQOL.

Incidence and Risk Factors of Cervical Kyphosis in Patients with Adolescent Idiopathic Scoliosis

BACKGROUND

Cervical kyphosis (CK) has been reported in patients with adolescent idiopathic scoliosis (AIS). The report about the incidence of CK between patients with AIS and normal populations was little. Patients included in previous studies often required scoliosis surgery (Cobb angle ≥40°), which does not represent all patients with AIS. The aims of this study were to compare incidence of CK between patients with AIS (Cobb angle >10°) and an age-matched normal population and to identify risk factors related to CK, especially coronal parameters that have rarely been studied in current literature.

METHODS

Patients with AIS (n = 112) and asymptomatic subjects from the general population (control group; n = 40) were retrospectively analyzed. Radiographic parameters of coronal and sagittal plane were measured on full-length spine x-rays. Patients with AIS were divided into 2 groups based on cervical lordosis angle: cervical lordosis and CK.

RESULTS

CK was observed in 14 of 40 (35%) subjects in the control group and 68 of 112 (60.7%) patients with AIS. Several parameters were related to CK, including major curve, proximal thoracic, and main thoracic Cobb angle; proximal thoracic kyphosis angle; main thoracic kyphosis angle; T1 slope; sagittal vertical axis; vertical distance between C7 plumb line and center sacral vertical line; apical vertebral translation; T1 coronal tilt; and lumbar pelvic relationship. Logistic regression identified main thoracic Cobb angle, main thoracic kyphosis angle, sagittal vertical axis, lumbar pelvic relationship, and apical vertebral translation as independent risk factors of CK.

CONCLUSIONS

Incidence of CK increases in patients with AIS relative to normal subjects. Coronal parameters of the spine could influence cervical sagittal alignment.