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Analysis of cervical sagittal alignment change following correction of thoracic and thoracolumbar Scheuermann’s kyphosis

European Spine Journal volume 26, pages 2187–2197 (2017)Cite this article

Abstract

Purpose

To analyse pre-operative and post-operative changes of cervical sagittal alignment (CSA) in Scheuermann’s kyphosis (SK) patients.

Methods

64 SK and 33 control patients were retrospectively reviewed. Whole spine X-rays obtained at pre-op, 3 months post-op and at latest follow-up were reviewed and ten separate CSA radiological parameters were measured. Patients were divided in three groups: thoracic SK (TK group, apex T6–T9, n = 40), thoracolumbar SK (TLK group, apex T10–T12, n = 24), and controls.

Results

Pre-operative C2–C7 lordosis was 21.1° ± 8.1°(TK), 6.1° ± 5.0°(TLK), and 11.4° ± 8.3° in control group and correlated significantly with T1 slope in both SK groups (r = 0.640, r = 0.772). Pre-operative T1 slope was dependent on deformity type, thoracic kyphosis (TK, β = 0.445), and lumbar lordosis (LL, β = −0.354). At final follow-up C2–C7 lordosis decreased to 15.7° ± 5.5° in TK, and increased to 12.1° ± 4.1° in TLK group. C2–C7 lordosis changes linearly correlated with T1 slope changes post-operatively (r = 0.721). Post-operative T1 slope showed linear correlation with post-operative changes in TK (β = 0.728) and pelvic tilt (PT, β = 0.539) in TK, and LL (β = −0.669), thoracolumbar kyphosis (TLK, β = −0.434), and PT (β = 0.760) in TLK group.

Conclusions

Our study suggests that SK is not a homogenous group of patients. Two patterns of pre- and post-operative CSA are demonstrated in TK and TLK groups. T1 slope is the most important parameter in determining pre-operative CSA and correlates with other regional anatomical parameters (TK and LL). Post-operative CSA adaptations also correlate with T1 slope post-operative changes. However, post-surgical T1 slope correlates with different parameters in the two SK groups (TK and PT in TK group; TLK, LL, and PT in TLK group).

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Authors and Affiliations

  1. The Centre for Spinal Studies and Surgery, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK

    Luigi Aurelio Nasto, Saggah Tarek Shalabi, Ana Belen Perez-Romera, Samiul Muquit, Amir Reza Ghasemi & Hossein Mehdian

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  1. Luigi Aurelio Nasto
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  2. Saggah Tarek Shalabi
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  3. Ana Belen Perez-Romera
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  4. Samiul Muquit
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  5. Amir Reza Ghasemi
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  6. Hossein Mehdian
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Correspondence to Luigi Aurelio Nasto.

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Nasto, L.A., Shalabi, S.T., Perez-Romera, A.B. et al. Analysis of cervical sagittal alignment change following correction of thoracic and thoracolumbar Scheuermann’s kyphosis. Eur Spine J 26, 2187–2197 (2017). https://doi.org/10.1007/s00586-017-5069-8

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  • DOI: https://doi.org/10.1007/s00586-017-5069-8

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