Study On Cervical Sagittal Curvature And Roussouly Sagittal Classification Of Adolescent Idiopathic Scoliosis

Objective To explore the correlation and possible influencing factors of imaging parameters between cervical curvature and Roussouly sagittal classification in adolescent idiopathic scoliosis(AIS).The purpose of this study is to provide a reasonable reference basis for the mode of operation,postoperative recovery and avoidance of postoperative complications in patients with AIS.Methods Retrospective analysis of patients with AIS included in the criteria,measurement and statistics of the standing position of the whole spine positive and lateral X-ray film of the following information: parietal cone position,scoliosis Cobb angle,cervical lordosis(CL),thoracic kyphosis angle(TK),lumbar kyphosis angle(LL),T1 slope,pelvic incidence angle(PI),pelvic inclination angle(PT),sacral inclination angle(SS),cervical sagittal axis(c SVA)and spinal sagittal axis(SVA).According to the spinal and pelvic curvature parameters,using Roussouly sagittal classification,patients with AIS were divided into 4 groups.Cervical curvature was classified into four groups: anterior protruding type,linear type,S type and kyphosis type.Results A total of 109 subjects were included,including 26 males(23.9%)and 83 females(76.1%).The age was 9-19 years old,the average age was 14.11 ±2.77 years old,and the Cobb angle was 23.78 ±11.15.There was no significant correlation between age,sex,Cobb angle and various parameters.There were 16 patients with Roussouly Ⅰ,37 patients with Roussouly Ⅲ,34 patients with Roussouly Ⅲ,18 patients with Roussouly Ⅳ 31 patients with anterior protrusion,45 patients with linear type,7 patients with S type and 26 patients with kyphosis.There was significant difference between Roussouly classification and sagittal classification of cervical vertebrae(P < 0.024).There was a strong correlation between SS and LL(r = 0.81),and a weak correlation between SS and TK(r = 0.213).There was a moderate correlation between),TK and LL and T1(r = 0.517,r = 0.675).There was a moderate correlation between PI and SS,LL and PT(r= 0.773,r=0.62,r= 0.536).There was a moderate negative correlation between C2-7 and TK,T1(r = 0.586),a slight negative correlation between C1-2 and C2-7(r = 0.328),a slight negative correlation between C1-7 and TK(r =0.458),and a moderate correlation between C1-7 and T1(r = 0.629).Although C2-7 was correlated with T1,TK and C1-2.There was no correlation between cervical vertebra parameters and spine and pelvis parameters,and there was no correlation between SS and T1,C1-7,C1-2,C2-7,c SVA.There was significant difference in LL among the four Roussouly types.There were differences in SS between Roussouly type Ⅰ and type Ⅲ and Ⅳ,and between Roussouly type Ⅱ and type Ⅲ and Ⅳ SS(P < 0.05).The PI of the four Roussouly types were different(P < 0 05).There was a difference between Roussouly type Ⅰ and type Ⅳ.There were significant differences in TK,T1,C2-7,C1-7 and SAV among the four types of cervical vertebrae,and there were significant differences in TK between anterior convex type and linear type and posterior convex type.The TK value of anterior convex type was significantly higher than that of linear type and posterior convex type,and the TK value of posterior convex type was significantly higher than that of S type.The angle of T1 in the anterior convex type was larger than that in the other three types,and the linear type and S type were also significantly larger than the posterior convex type(P < 0.05)the C2-7 of the anterior convex type was significantly larger than that of the linear type and the posterior convex type(P < 0.05),and the C2-7 of the linear type was significantly larger than that of the posterior convex type(P < 0.05).The,(P of the linear type was significantly larger than that of the posterior convex type.The C1-7 of protruding type was significantly higher than that of linear type and posterior convex type(P < 0.05).There was significant difference in SAV between anterior convex type and linear type(P < 0.05).Conclusion Roussouly classification and the cervical spine sagittal classification may be related.The pelvic-spine sagittal parameters have a certain influence on the cervical spine sagittal parameters.Compared with normal adolescents,the proportion of Roussouly type I and type II in AIS patients has increased.The proportion of non-lordotic cervical spine patients with AIS increased significantly(71.6%).