Cervical spine sagittal alignment following surgical correction of Lenke type 1 idiopathic scoliosis – early results

2021 ◽  
Author(s):  
P Janusz ◽  
Ł Stepniak ◽  
T Kotwicki
Keyword(s):  
Cervical Spine ◽  
Idiopathic Scoliosis ◽  
Sagittal Alignment ◽  
Surgical Correction ◽  
Early Results

scholarly journals Normal Age-Adjusted Sagittal Spinal Alignment Is Achieved with Surgical Correction in Adolescent Idiopathic Scoliosis

2017 ◽  
Vol 11 (5) ◽  
pp. 770-779 ◽  
Author(s):  
Subaraman Ramchandran ◽  
Norah Foster ◽  
Akhila Sure ◽  
Thomas J. Errico ◽  
Aaron J. Buckland
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Vertical Axis ◽  
Surgical Correction ◽  
Sagittal Vertical Axis

<sec><title>Study Design</title><p>Retrospective analysis.</p></sec><sec><title>Purpose</title><p>Our hypothesis is that the surgical correction of adolescent idiopathic scoliosis (AIS) maintains normal sagittal alignment as compared to age-matched normative adolescent population.</p></sec><sec><title>Overview of Literature</title><p>Sagittal spino-pelvic alignment in AIS has been reported, however, whether corrective spinal fusion surgery re-establishes normal alignment remains unverified.</p></sec><sec><title>Methods</title><p>Sagittal profiles and spino-pelvic parameters of thirty-eight postsurgical correction AIS patients ≤21 years old without prior fusion from a single institution database were compared to previously published normative age-matched data. Coronal and sagittal measurements including structural coronal Cobb angle, pelvic incidence, pelvic tilt, thoracic kyphosis, lumbar lordosis, sagittal vertical axis, C2–C7 cervical lordosis, C2–C7 sagittal vertical axis, and T1 pelvic angles were measured on standing full-body stereoradiographs using validated software to compare preoperative and 6 months postoperative changes with previously published adolescent norms. A sub-group analysis of patients with type 1 Lenke curves was performed comparing preoperative to postoperative alignment and also comparing this with previously published normative values.</p></sec><sec><title>Results</title><p>The mean coronal curve of the 38 AIS patients (mean age, 16±2.2 years; 76.3% female) was corrected from 53.6° to 9.6° (80.9%, <italic>p</italic>&lt;0.01). None of the thoracic and spino-pelvic sagittal parameters changed significantly after surgery in previously hypo- and normo-kyphotic patients. In hyper-kyphotic patients, thoracic kyphosis decreased (<italic>p</italic>=0.003) with a reciprocal decrease in lumbar lordosis (<italic>p</italic>=0.01), thus lowering pelvic incidence-lumbar lordosis mismatch mismatch (<italic>p</italic>=0.009). Structural thoracic scoliosis patients had slightly more thoracic kyphosis than age-matched patients at baseline and surgical correction of the coronal plane of their scoliosis preserved normal sagittal alignment postoperatively. A sub-analysis of Lenke curve type 1 patients (n=24) demonstrated no statistically significant changes in the sagittal alignment postoperatively despite adequate coronal correction.</p></sec><sec><title>Conclusions</title><p>Surgical correction of the coronal plane in AIS patients preserves sagittal and spino-pelvic alignment as compared to age-matched asymptomatic adolescents.</p></sec>

Sagittal alignment of cervical spine in adult idiopathic scoliosis

2015 ◽  
Vol 24 (6) ◽  
pp. 1175-1182 ◽  
Author(s):  
Bilal Aykac ◽  
◽  
Selim Ayhan ◽  
Selcen Yuksel ◽  
Umit Ozgur Guler ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Idiopathic Scoliosis ◽  
Sagittal Alignment

scholarly journals Cervical sagittal alignment and the impact of posterior spinal instrumented fusion in patients with Lenke type 1 adolescent idiopathic scoliosis

2018 ◽  
Vol 4 (2) ◽  
pp. 342-348
Author(s):  
Ryan J. Berger ◽  
Assem A. Sultan ◽  
Joseph E. Tanenbaum ◽  
William A. Cantrell ◽  
David P. Gurd ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Sagittal Alignment ◽  
Instrumented Fusion ◽  
Cervical Sagittal Alignment ◽  
The Impact

The Sagittal Alignment of the Cervical Spine in Adolescent Idiopathic Scoliosis

1995 ◽  
Vol 15 (5) ◽  
pp. 627-632 ◽  
Author(s):  
Alan S. Hilibrand ◽  
Darryl A. Tannenbaum ◽  
Gregory P. Graziano ◽  
Randall T. Loder ◽  
Robert N. Hensinger
Keyword(s):  
Cervical Spine ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Sagittal Alignment

Surgical correction of severe cervical kyphosis in patients with neurofibromatosis Type 1

2013 ◽  
Vol 18 (3) ◽  
pp. 274-279 ◽  
Author(s):  
Soya Kawabata ◽  
Kota Watanabe ◽  
Naobumi Hosogane ◽  
Ken Ishii ◽  
Masaya Nakamura ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neurofibromatosis Type 1 ◽  
Spinal Instrumentation ◽  
Neurofibromatosis Type ◽  
Surgical Correction ◽  
Cervical Kyphosis ◽  
Halo Vest ◽  
Bone Fusion ◽  
Posterior Correction

Severe cervical kyphosis requiring surgical treatment is rare in patients with neurofibromatosis Type 1 (NF1). When it occurs, however, dystrophic changes in the vertebrae make surgical correction and fusion of the deformity extremely difficult. The authors report on 3 cases of severe cervical kyphosis associated with NF1 that were successfully treated with combined anterior and posterior correction and fusion. All patients underwent halo-gravity traction for approximately 1 month prior to surgery to correct the deformity gradually. Posterior correction and fusion were performed with segmental spinal instrumentation consisting of lateral mass screws, lamina screws, pedicle screws, and polyethylene tape for sublaminar wiring. Anterior spinal fusion was performed using a fibula strut to induce solid bone fusion. All patients used a halo vest for postoperative external fixation. Preoperative CT scans showed dystrophic cervical spine changes, and MR images demonstrated extensive neurofibromas outside the cervical spine in all 3 patients. The preoperative kyphotic angles were as follows: Case 1, 140°; Case 2, 81°; and Case 3, 72°; after halo-gravity traction, the kyphosis angles improved to 50°, 55°, and 51°, respectively; and after surgery, they were 50°, 15°, and 27°, respectively. Solid bone union was observed in all patients at the latest follow-up. All three patients experienced postoperative complications consisting of superficial infection, severe pneumonia, and partial dislocation of the distal fibula graft after removing the halo vest, in one patient each. Although dystrophic cervical vertebral changes in these patients with NF1 complicated the correction of severe cervical kyphosis, the use of preoperative halo-gravity traction, a combination of spinal instrumentations, an anterior strut bone graft, and postoperative halo-vest fixation made it possible to correct the kyphosis, maintain the correction, and achieve solid bone fusion.

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