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Li J, Deng K, Tang Y, Yang Z, Liu X, Liu Z, Wei F, Wu F, Zhou H, Li Y, Wang Y, Li W, Yu M. Postoperative alterations of sagittal cervical alignment and risk factors for cervical kyphosis in 124 Lenke 1 adolescent idiopathic scoliosis patients. BMC Musculoskelet Disord 2021; 22:1001. [PMID: 34847890 PMCID: PMC8630904 DOI: 10.1186/s12891-021-04884-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022] Open
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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Affiliation(s)
- Junyu Li
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Kaige Deng
- Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yanchao Tang
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Zexi Yang
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Xiaoguang Liu
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Zhongjun Liu
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Feng Wei
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Fengliang Wu
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Hua Zhou
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yan Li
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yongqiang Wang
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Weishi Li
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Miao Yu
- Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China. .,Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing, 100191, China. .,Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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