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Analysis of the cervical spine sagittal alignment in young idiopathic scoliosis: a morphological classification of 120 cases.
Eur Spine J. 2013 Nov; 22(11):2372-81.ES

Abstract

PURPOSE

To analyze the relationship between the cervical spine and global spinal-pelvic alignment in young patients with idiopathic scoliosis based on a morphological classification, and to postulate the hypothesis that cervical kyphosis is a part of cervico-thoracic kyphosis in them.

METHODS

120 young patients with idiopathic scoliosis were recruited retrospectively between 2006 and 2011. The following values were measured and calculated: cervical angles (CA), cervico-thoracic angles (CTA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), spinal sacral angle (SSA), hip to C7/hip to sacrum, thoracic kyphosis (TK), lumbar lordosis (LL), Roussouly sagittal classification, Lenke Type Curve and Lumbar Modifier. The cervical curves were classified as lordosis, straight, sigmoid and kyphosis. They were categorized into four groups as cervical non-kyphosis group (CNK Group), cervical kyphosis group (CK Group), cervical-middle-thoracic kyphosis group (CMTK Group), and cervical-lower-thoracic kyphosis group (CLTK Group) according to their morphological characters of sagittal alignments. All parameters were compared and analyzed among groups.

RESULTS

The incidence of cervical kyphosis was 40 % (48/120). The CA and the CTA were in significant correlation (r = 0.854, P = 0.00). The cervical spine alignments were revealed to be significantly different among groups (r = 85.04, P = 0.00). Significant differences among groups in CA, CTA and TK were also detected. A strong correlation between the group type and Lenke Lumbar Modifier was still seen (P < 0.05). Fisher's exact test revealed that the individual vertebral body kyphosis and wedging were directly related to the overall cervical kyphosis (P = 0.00, respectively).

CONCLUSION

The cervical kyphosis is correlated with global sagittal alignment, and is a part of cervico-thoracic sagittal deformity in young patients with idiopathic scoliosis. Despite the deformity in cervical alignment, the global spine could still be well-balanced with spontaneous adjustment. The correlation between our grouping based on the morphological characteristics of the sagittal alignments and Lenke Lumbar Modifier suggests that the coupled motion principle be appropriate to explain the modifications both in coronal and sagittal planes.

Authors+Show Affiliations

Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, China, miltonyu1977@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23580056

Citation

Yu, Miao, et al. "Analysis of the Cervical Spine Sagittal Alignment in Young Idiopathic Scoliosis: a Morphological Classification of 120 Cases." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 22, no. 11, 2013, pp. 2372-81.
Yu M, Silvestre C, Mouton T, et al. Analysis of the cervical spine sagittal alignment in young idiopathic scoliosis: a morphological classification of 120 cases. Eur Spine J. 2013;22(11):2372-81.
Yu, M., Silvestre, C., Mouton, T., Rachkidi, R., Zeng, L., & Roussouly, P. (2013). Analysis of the cervical spine sagittal alignment in young idiopathic scoliosis: a morphological classification of 120 cases. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 22(11), 2372-81. https://doi.org/10.1007/s00586-013-2753-1
Yu M, et al. Analysis of the Cervical Spine Sagittal Alignment in Young Idiopathic Scoliosis: a Morphological Classification of 120 Cases. Eur Spine J. 2013;22(11):2372-81. PubMed PMID: 23580056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analysis of the cervical spine sagittal alignment in young idiopathic scoliosis: a morphological classification of 120 cases. AU - Yu,Miao, AU - Silvestre,Clement, AU - Mouton,Tanguy, AU - Rachkidi,Rami, AU - Zeng,Lin, AU - Roussouly,Pierre, Y1 - 2013/04/12/ PY - 2012/03/17/received PY - 2013/03/15/accepted PY - 2013/03/05/revised PY - 2013/4/13/entrez PY - 2013/4/13/pubmed PY - 2014/12/30/medline SP - 2372 EP - 81 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 22 IS - 11 N2 - PURPOSE: To analyze the relationship between the cervical spine and global spinal-pelvic alignment in young patients with idiopathic scoliosis based on a morphological classification, and to postulate the hypothesis that cervical kyphosis is a part of cervico-thoracic kyphosis in them. METHODS: 120 young patients with idiopathic scoliosis were recruited retrospectively between 2006 and 2011. The following values were measured and calculated: cervical angles (CA), cervico-thoracic angles (CTA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), spinal sacral angle (SSA), hip to C7/hip to sacrum, thoracic kyphosis (TK), lumbar lordosis (LL), Roussouly sagittal classification, Lenke Type Curve and Lumbar Modifier. The cervical curves were classified as lordosis, straight, sigmoid and kyphosis. They were categorized into four groups as cervical non-kyphosis group (CNK Group), cervical kyphosis group (CK Group), cervical-middle-thoracic kyphosis group (CMTK Group), and cervical-lower-thoracic kyphosis group (CLTK Group) according to their morphological characters of sagittal alignments. All parameters were compared and analyzed among groups. RESULTS: The incidence of cervical kyphosis was 40 % (48/120). The CA and the CTA were in significant correlation (r = 0.854, P = 0.00). The cervical spine alignments were revealed to be significantly different among groups (r = 85.04, P = 0.00). Significant differences among groups in CA, CTA and TK were also detected. A strong correlation between the group type and Lenke Lumbar Modifier was still seen (P < 0.05). Fisher's exact test revealed that the individual vertebral body kyphosis and wedging were directly related to the overall cervical kyphosis (P = 0.00, respectively). CONCLUSION: The cervical kyphosis is correlated with global sagittal alignment, and is a part of cervico-thoracic sagittal deformity in young patients with idiopathic scoliosis. Despite the deformity in cervical alignment, the global spine could still be well-balanced with spontaneous adjustment. The correlation between our grouping based on the morphological characteristics of the sagittal alignments and Lenke Lumbar Modifier suggests that the coupled motion principle be appropriate to explain the modifications both in coronal and sagittal planes. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/23580056/Analysis_of_the_cervical_spine_sagittal_alignment_in_young_idiopathic_scoliosis:_a_morphological_classification_of_120_cases_ L2 - https://doi.org/10.1007/s00586-013-2753-1 DB - PRIME DP - Unbound Medicine ER -