The Sagittal Alignment of the Cervical Spine in Adolescent Idiopathic Scoliosis

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Abstract
Summary: To assess the sagittal orientation of the cervical and thoracolumbar spine, 38 adolescents with idiopathic scoliosis were studied. The C7 plumb line and Cobb angles from C2-6, Tl-12, and Ll-Sl were measured on preoperative films. Lateral radiographs with >l-year follow-up after surgical correction were available for the same measurements in 28 patients. The preoperative curve from C2-6 was 6 ± 11° of kyphosis. There was a significant correlation between the loss of thoracic kyphosis and the development of cervical kyphosis for the entire group preoperatively (p=0.009). Postoperatively, cervical kyphosis increased to 11 ± 9° at 1-year follow-up (p=0.05). There was no progression of cervical kyphosis in patients with “thoracic hypokyphosis” (kyphosis 40°) after surgery, despite preservation of thoracolumbar sagittal contour. There were no significant differences between the sagittal contour of patients treated with Cotrel-Dubousset or Harrington instrumentation.

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