Aston University, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
J Anat. 2022 Aug;241(2):437-446. doi: 10.1111/joa.13662. Epub 2022 Apr 4.
The relationship between the sagittal shape of the cervical spine and that of the thoracolumbar spine is established in the normal spine. Adolescent idiopathic scoliosis (AIS) is recognised as a change in the shape of the spine in both the coronal and sagittal planes. The effects of AIS on the alignment of the cervical spine, including the effects of surgery, has been less well studied. The objective of this study was to identify, using regression analysis, the significant relationships between the alignment of the thoracolumbar spine, in both the coronal and sagittal planes, and the sagittal alignment of the cervical spine in AIS. This study used coronal and sagittal radiographic measures from a group with AIS, both pre and post-operatively, which were analysed using multiple linear regression methods to identify significant parameters that explain the sagittal shape of the cervical spine. There were 51 pairs of pre and post-operative radiographs analysed, 40 of which were Lenke 1 curves and 11 Lenke 3 curves. Posterior spinal fusion was performed for all. The significant parameters pre-operatively were T1 slope, thoracic kyphosis, lumbar lordosis and SVA with an R value of 78%. Post-operatively, the significant parameters were T1 slope, thoracic kyphosis, lumbar lordosis and thoracolumbar scoliosis with an R of 63%. The sagittal alignment of the cervical spine in AIS is related to the shape of key parameters in the rest of the spine. Changes in the cervical sagittal shape occur to compensate for changes in shape to the rest of the spine that occur as a consequence of surgery. This has implications for the understanding of how the compensatory mechanisms of the spine are used to maintain a horizontal gaze, along with prediction of the effects of surgery on the shape of the spine.
颈椎矢状形状与胸腰椎矢状形状的关系在正常脊柱中建立。青少年特发性脊柱侧凸（AIS）被认为是脊柱冠状面和矢状面形状的变化。AIS 对颈椎排列的影响，包括手术的影响，研究得较少。本研究的目的是使用回归分析确定，在 AIS 中，胸腰椎在冠状面和矢状面的排列与颈椎矢状排列之间的显著关系。本研究使用了一组 AIS 患者的术前和术后冠状位和矢状位 X 线片，使用多元线性回归方法进行分析，以确定解释颈椎矢状形状的显著参数。分析了 51 对术前和术后 X 线片，其中 40 对为 Lenke 1 曲线，11 对为 Lenke 3 曲线。所有患者均行后路脊柱融合术。术前的显著参数是 T1 斜率、胸椎后凸、腰椎前凸和 SVA，R 值为 78%。术后，显著参数为 T1 斜率、胸椎后凸、腰椎前凸和胸腰椎侧凸，R 值为 63%。AIS 中颈椎的矢状排列与脊柱其余部分关键参数的形状有关。颈椎矢状形状的变化是为了补偿手术引起的脊柱其余部分形状变化而发生的。这对理解脊柱的代偿机制如何用于维持水平注视以及预测手术对脊柱形状的影响具有重要意义。
