Radiographic Analysis Of Cervical Sagittal Curvature And Sagittal Spino-pelvic Alignment In Adolescent Idiopathic Scoliosis Patients

Objective: To evaluate the characteristics of cervical curvature and to analyze the relationship between the cervical spine with global spino-pelvic alignment and possible influencing factors in adolescent idiopathic scoliosis.Providing a more scientific and reasonable imaging reference for the clinical diagnosis,treatment and prognosis of spinal deformity.Methods:A retrospective analysis of adolescent idiopathic scoliosis(AIS)patients with complete radiographic data was performed.The following parameters were measured: Cobb angles of the scoliosis,cervical lordosis(CL),thoracic kyphosis(TK),lumbar lordosis(LL),T1 slope,pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),cervical sagittal vertical axis(c SVA)and sagittal vertical axis(SVA).CL> 5 ° for the cervical lordosis group;CL:-5 ° ~ 5 ° for the cervical straighten group;CL <-5 ° for the kyphosis grou.Thoracic kyphosis normal group: TK: 20 ° ~ 40 °;thoracic kyphosis aggravation group: TK> 40 ° and thoracic kyphosis reduction group: TK <20 °.Spinal sagittal balance group: | SVA | ? 5cm and spine sagittal plane imbalance group: | SVA |> 5cm.Cervical sagittal plane balance group: | c SVA | ? 4cm and cervical sagittal plane imbalance group: | c SVA |> 4cm.The patients were divided into two groups ranging from 13 ° to 25 °and beyond the range according to T1 slope.Results: A total of 114 subjects were enrolled in the study.There were 30 males and 84 females with an average age of 14.89 ± 2.11 years.The mean values for the CL was-4.28°±13.95°.34 cases of cervical straighten group(-5 ° ~ 5 °)and 62 cases of cervical kyphosis group(CL <-5 °).Thoracic kyphosis aggravation group(TK> 40 °): 4 cases,thoracic kyphosis reduction group(TK <20 °): 26 cases.In patients with AIS,CL was positively correlated with TK(r = 0.664,P = 0.000)and T1 slope(r= 0.661,P= 0.000).T1 slope and TK(r= 0.447,P= 0.000)were positively correlated with.When controlled T1 slope,CL was not associated with TK(r= 0.171,P= 0.208).TK was mildly correlated with LL(r= 0.319,P= 0.016).When controlled SS,there was correlation between CL and LL(r= 0.281,P= 0.036).There were no correlation between years/ Cobb angle and sagittal parameters in AIS patients(P> 0.05).LL was correlated with pelvic parameters(SS,PI,PT)(P<0.05),and LL was strongly correlated with SS(r= 0.873,P=0.000).T1 slope was slightly positively correlated with SVA(P<0.05).There were significant differences in TK,LL and T1 slope between different groups of CL(P<0.05).And the mean value of TK,LL and T1 slope decreased with CL descending.There were significant differences in CL and T1 slope between different groups of TK(P<0.05),and with the increase of TK,CL and T1 slope between the three groups gradually increased.Conclusions: AIS patients has a higher proportion of cervical kyphosis(54.4%),and CL is significantly lower than the normal value past literature reported.CL and TK are slightly positively correlated and are significantly affected by T1 slope.When control SS,there is net correlation between CL and LL: the change of CL may be affected by LL.These are compensatory changes that in order to maintain the balance of the body.There is no correlation found between the cervical curvature and pelvic parameters.