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

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 instru...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Adolescent idiopathic scoliosis pedicle screws cervical sagittal compensation cervical kyphosis independent risk factors Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/3edba7a099484ac9bb70b038c7f5a561
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spelling	oai:doaj.org-article:3edba7a099484ac9bb70b038c7f5a5612021-12-05T12:18:17ZPostoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients10.1186/s12891-021-04884-41471-2474https://doaj.org/article/3edba7a099484ac9bb70b038c7f5a5612021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04884-4https://doaj.org/toc/1471-2474Abstract 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.Junyu LiKaige DengYanchao TangZexi YangXiaoguang LiuZhongjun LiuFeng WeiFengliang WuHua ZhouYan LiYongqiang WangWeishi LiMiao YuBMCarticleAdolescent idiopathic scoliosispedicle screwscervical sagittal compensationcervical kyphosisindependent risk factorsDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Adolescent idiopathic scoliosis pedicle screws cervical sagittal compensation cervical kyphosis independent risk factors Diseases of the musculoskeletal system RC925-935
spellingShingle	Adolescent idiopathic scoliosis pedicle screws cervical sagittal compensation cervical kyphosis independent risk factors Diseases of the musculoskeletal system RC925-935 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 Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients
description	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.
format	article
author	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
author_facet	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
author_sort	Junyu Li
title	Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients
title_short	Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients
title_full	Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients
title_fullStr	Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients
title_full_unstemmed	Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients
title_sort	postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 lenke 1 adolescent idiopathic scoliosis patients
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3edba7a099484ac9bb70b038c7f5a561
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Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients

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