Background: Treatment of adolescent idiopathic scoliosis (AIS) is one of the most challenging problems for spine surgeons. Although it has been previously demonstrated that curve pattern in AIS is different between males and females, there are, however, limited studies specially focused on the differences of AIS characteristics between the two genders. Objectives: In current study, we compared the demographics and curve patterns in male and female patients with AIS. Patients and Methods: A total of 68 girls and 17 boys with AIS were included in this cross-sectional study. The magnitude of curvature, thoracic kyphosis, flexibility and pattern of the deformity were measured on x-rays and compared between the two genders. Results: Although girls were significantly younger (15.3 ± 2.5 versus 16.7 ± 2.1 years; P = 0.036), however, the Risser sign was the same. Most of the males were hypokyphotic (70.6%), while most of the girls had normal thoracic kyphosis (69.1%) (P = 0.001). The main scoliotic curve (77.2 ± 18.2 versus 59.6 ± 18.6 degrees) and flexibility (25.5% ± 18.2% versus 41.9% ± 18.6%) were significantly greater and lower in males, respectively (P < 0.05). The typical AIS pattern was present in 64.7% of boys and 95.6% of girls (P < 0.001). Conclusions: The radiographic characteristics of AIS are substantially different between genders. In male patients, AIS is more severe and rigid compared to females. Also, hypokyphosis and atypical pattern of AIS are common findings in males compared to females.
Background:Recently, several authors have demonstrated the importance of sagittal spinopelvic alignment in patients with adolescent idiopathic scoliosis (AIS). Objectives: In the current study, we investigated the preoperative spinal and pelvic sagittal parameters in the abovementioned patients. Patients and Methods: There were 50 consecutive patients with AIS (16 males and 34 females) in the current prospective study. In addition to the measurement of main scoliotic curve on posteroanterior X-rays, pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), and thoracic kyphosis (TK) were measured on lateral X-rays. Finally, the correlations between these parameters were investigated. We also compared the sagittal parameters between patients with main thoracic scoliosis (Lenke type I) and thoracolumbar/lumbar scoliosis (Lenke type V). Results: Main scoliotic curve (MSC) was correlated with TK and PT. LL was correlated positively with PI and SS. Negative correlation was found between SS and PI. The sagittal parameters were the same in patients with Lenke type I and Lenke type V scoliosis. In addition, MSC and LL were significantly greater in patients with thoracolumbar/lumbar scoliosis, while TK was significantly greater in patients with main thoracic scoliosis. In the main thoracic group, MSC and TK were positively and PI was negatively correlated with PT. LL and SS had a positive correlation. Conclusions: PI has a constant magnitude and is correlated with SS and LL. Postoperatively, pelvis can compensate for any change in LL. Therefore, the LL within fusion must be imposed in lordosis to the extent that the below fusion segments can compensate for intrafusion hypo/hyper lordosis to prevent the pelvis to compensate for hypo/hyper lordosis. This can result in a normal or near normal postoperative sagittal alignment. The authors recommend the surgeons to perform exact preoperative planning including the sagittal alignment of the pelvis in addition to spinal alignment.
Background: Recent studies have revealed the increasing importance of sagittal spinopelvic alignment. Knowing the values of sagittal spinopelvic parameters, which are affected by ethnicity, is essential in the normal asymptomatic population. In the current study, these parameters were measured in a sample of asymptomatic Iranian population. Methods: Seventy asymptomatic participants without complaint of musculoskeletal problems were enrolled. They had no complaint about musculoskeletal problems. Lateral full-length spinal and pelvic x–rays were taken. The following parameters were measured on x-rays and presented as mean ± standard deviation: pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), lumbar tilt (LT) and thoracic tilt (TT). Results: The population consisted of 37 males and 33 females aged 26.6 ± 4.27 years. The mean values of PI, SS, PT, LL, TK, LT, and TT were 44.5 ± 10.1, 35.4 ± 6.7, 9.1 ± 7.9, 41.9 ± 14.7, 28.8 ± 8.3, 11.9 ± 7.4 and –7.5 ± 5.7 (median: –10; 5th percentile: –14; 95th percentile: 4.4) degrees, respectively. The variables were similar between males and females except for LL which was significantly higher in females (37.8 ± 16.5 versus 46.5 ± 11; P = 0.013). In addition, the linear regression model revealed age to be independently related with PI (beta = 0.344; P = 0.004) and PT (beta = 0.366; P = 0.002). PI (r = 0.344, P = 0.004) and PT (r = 0.359, P = 0.002) were positively correlated with age. Additionally, PI was positively correlated to SS, PT and LL and negatively to TT. Conclusion: These findings may be used as referential values for sagittal spinopelvic parameters in the Iranian population. The positive correlation of PI with age questions the constancy of PI throughout life. However, larger studies are required.
Background: Treatment of adolescent idiopathic scoliosis (AIS) is one of the most challenging problems for spine surgeons. Although it has been previously demonstrated that curve pattern in AIS is different between males and females, there are, however, limited studies specially focused on the differences of AIS characteristics between the two genders. Objectives: In current study, we compared the demographics and curve patterns in male and female patients with AIS. Patients and Methods: A total of 68 girls and 17 boys with AIS were included in this cross-sectional study. The magnitude of curvature, thoracic kyphosis, flexibility and pattern of the deformity were measured on x-rays and compared between the two genders. Results: Although girls were significantly younger (15.3 ± 2.5 versus 16.7 ± 2.1 years; P = 0.036), however, the Risser sign was the same. Most of the males were hypokyphotic (70.6%), while most of the girls had normal thoracic kyphosis (69.1%) (P = 0.001). The main scoliotic curve (77.2 ± 18.2 versus 59.6 ± 18.6 degrees) and flexibility (25.5% ± 18.2% versus 41.9% ± 18.6%) were significantly greater and lower in males, respectively (P < 0.05). The typical AIS pattern was present in 64.7% of boys and 95.6% of girls (P < 0.001). Conclusions:The radiographic characteristics of AIS are substantially different between genders. In male patients, AIS is more severe and rigid compared to females. Also, hypokyphosis and atypical pattern of AIS are common findings in males compared to females.
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