Comparison of Sagittal Spinopelvic Alignment in Chinese Adolescents with and without Idiopathic Thoracic Scoliosis.

By London Spine

Comparison of Sagittal Spinopelvic Alignment in Chinese Adolescents with and without Idiopathic Thoracic Scoliosis.

Spine (Phila Pa 1976). 2011 Dec 13;

Authors: Yong Q, Zhen L, Zezhang Z, Bangping Q, Feng Z, Tao W, Jun J, Xu S, Xusheng Q, Weiwei M, Weijun W

ABSTRACT: Study Design.. retrospective radiographic study investigated the sagittal alignment in healthy Chinese girls and Chinese girls with idiopathic thoracic scoliosis (T-AIS).Objective. To evaluate the sagittal alignment of the pelvis and spine in Chinese females with idiopathic scoliosis and healthy girls, and to assess whether the pelvic morphology differed between Caucasian and Chinese girls with AIS.Summary of Background Data. It has been shown that AIS patients have an abnormal spinopelvic balance and pelvic morphology. Race is a determinant factor of sagittal spinal alignment and serves as a reminder when planning surgical reconstruction for spinal deformity. Up to now, there have been no studies documenting the sagittal lumbosacral spine morphology in Chinese T-AIS girls.Methods. In this study, 95 T-AIS patients and 33 healthy age-matched adolescents were recruited consecutively. Sagittal spinal and pelvic parameters were measured from the standing lateral radiograph, including thoracic kyphosis (TK), lumbar lordosis (LL), upper arc of lumbar lordosis, lower arc of lumbar lordosis, pelvic incidence (PI), sacrum slope (SS), and pelvic tilt (PT). Analysis of variance was used in the comparison of each dependent variable between AIS patients and normal adolescents. The relations between all parameters were determined via Pearson’s correlation coefficient (r).Results. For all the sagittal parameters, only the TK and the upper arc of the lumbar lordosis showed significant differences between AIS girls and normal girls. The LL, lower arc of the lumbar lordosis, and three pelvic parameters were similar for both groups. The TK was found to be strongly correlated with LL and the upper arc of the lumbar lordosis in both groups. However, the TK was not related to the lower arc of the lumbar lordosis, nor were the three pelvic parameters in either group. In addition, LL was found to be associated with PI and SS in both groups. The lower arc of the lumbar lordosis was also correlated with PI for both groups. The PI was related to PT and SS in both groups, however, no correlation was found between PT and SS. In this study, the TK (15.7), SS (35.1) and PI (44.2) were found to be significantly lower in Chinese T-AIS patients when compared with the values reported in the AIS cohort.Conclusion. In our study, the Chinese T-AIS girls had similar PI, PT and SS values when compared with the age-matched normal girls. There were significant differences in pelvic morphology between Chinese and Caucasian AIS girls. These results suggest that race may influence an individual’s spinopelvic morphology. While we have shown that the TK could affect LL through the upper arc of the LL directly, the evaluation of the thoracolumbar morphology of T-AIS before surgery is important for surgical planning.

PMID: 22166928 [PubMed – as supplied by publisher]