Analysis of cervical sagittal alignment change following correction of thoracic and thoracolumbar Scheuermann’s kyphosis

Nasto, Luigi Aurelio; Shalabi, S.T.; Perez-Romera, A.B.; Muquit, Samiul; Ghasemi, Amir Abbas; Mehdian, Hossein

doi:10.1007/s00586-017-5069-8

Cited by 9 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We identified that an increased TK was associated with an increased CL, while patients with a large TLK had less CL. This is similar to previous studies that also described increased Long-term follow-up of untreated Scheuermann's kyphosis 11 TK leading to an anteriorly projected cervical spine, whereas TLK was associated with a vertically oriented cervical spine [24]. Increased TK is associated with increased cSVA and CL, which may contribute to increased pain [25].…”

Section: Discussionsupporting

confidence: 90%

Long-term follow-up of untreated Scheuermann’s kyphosis

et al. 2021

View full text Add to dashboard Cite

Study Design: Long-term cross-sectional studyObjectives: To investigate long-term effects of untreated Scheuermann's kyphosis on quality of life, and its relationship to radiographic parameters of spinal deformity. Summary of background data:Previous studies reported reduced self-image, increased pain and impaired physical status. Little is known of the long-term impact of sagittal plane deformity in untreated SK.Methods: 113 consecutive untreated patients with SK were identified from a national service database prior to 2000, when surgery was not offered at this unit. 81 of these patients were available for evaluation; 66 (81%) consented to questionnaire and clinical evaluation, and 47 (58%) consented to additional radiological evaluation. Health-related quality of life (HRQoL) was compared to normative population values. Mean age was 45.1 years (31-65), and mean follow-up was 27 years (16-36). 57 patients had thoracic kyphosis and 9 had thoracolumbar deformity.Results: SRS-22 and SF-36 scores were lower, and ODI was greater in patients with untreated SK compared to normative population values. Kyphosis progressed from mean 66 o at skeletal maturity to 78 o (p<0.001) after mean follow-up of 27 years. Long-term progression of untreated SK was 0.45 o /year (n=47). Multilinear regression showed good correlation between increasing SVA and worse ODI scores (r=0.59; p=0.001). Increasing SVA also correlated with worse function, pain, and mental health scores reported by SRS-22, and with worse physical function and bodily pain scores reported by SF-36. Increasing CL correlated with worse SF-36 physical function scores. Increasing cSVA and increasing TK correlated with worse SRS-22 self-image scores. Conclusion:SRS-22 and SF-36 scores were lower, and ODI was greater in patients with untreated SK compared to normative data. Long-term progression of untreated SK was Long-term follow-up of untreated Scheuermann's kyphosis 2 0.45 o /year (n=47). Increasing SVA correlated with worse SF-36 physical function, SRS-22 function, SRS-22 pain, and higher ODI scores. Total kyphosis (TK) and cSVA were independent predictors of low SRS self-image. Level of Evidence: III Key Points:• Subjective quality of life measures are worse in patients with untreated Scheuermann's kyphosis compared to the normative population values.• Long-term progression of untreated Scheuermann's kyphosis is 0.45 o /year.• Total kyphosis and cSVA were independent predictors of low reported self-image.• SVA correlated with increased disability and severity of symptoms, as reported by health-related quality of life (HRQoL) measures.

show abstract

Section: Discussionsupporting

confidence: 90%

Long-term follow-up of untreated Scheuermann’s kyphosis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In terms of proximal alignment, T1S has been shown previously to be a predictor of overall cervical sagittal alignment. 21,22 The results of the present study support these previous findings and further suggest that among patients with PJK, there is a significant correlation between the degree of focal deformity (ie, PJA) and the T1S with an associated positive correlation with CL and anterior cervical or cervicothoracic sagittal alignment. This was irrespective of UT or LT UIV (Table 5).…”

Section: Discussionsupporting

confidence: 90%

Cervical, Thoracic, and Spinopelvic Compensation After Proximal Junctional Kyphosis (PJK): Does Location of PJK Matter?

Kim

Elysée

Shaffrey

et al. 2019

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Retrospective case series. Objective: Compensatory changes above a proximal junctional kyphosis (PJK) have not been defined. Understanding these mechanisms may help determine optimal level selection when performing revision for PJK. This study investigates how varying PJK location changes proximal spinal alignment. Methods: Patients were grouped by upper instrumented vertebrae (UIV): lower thoracic (LT; T8-L1) or upper thoracic (UT; T1-7). Alignment parameters were compared. Correlation analysis was performed between PJK magnitude and global/cervical alignment. Results: A total of 369 patients were included; mean age of 63 years, body mass index 28, and 81% female, LT (n = 193) versus UT (n = 176). The rate of radiographic PJK was 49%, higher in the LT group (55% vs 42%, P = .01). The UT group displayed significant differences in all cervical radiographic parameters ( P < .05) between PJK versus non-PJK patients, while the LT group displayed significant differences in T1S and C2-T3 sagittal vertical axis (SVA) (CTS). In comparing UT versus LT patients, UT had more posterior global alignment (smaller TPA [T1 pelvic angle], SVA, and larger PT [pelvic tilt]) and larger anterior cervical alignment (greater cSVA [cervical SVA], T1S-CL [T1 slope–cervical lordosis] mismatch, CTS) compared to LT. Correlation analysis of PJK magnitude and location demonstrated a correlation with increases in CL, T1S, and CTS in the UT group. In the LT group, PT increased with PJK angle ( r = 0.17) and no significant correlations were noted to SVA, cSVA, or T1S-CL. Conclusions: PJK location influences compensation mechanisms of the cervical and thoracic spine. LT PJK results in increased PT and CL with decreased CTS. UT PJK increases CL to counter increases in T1S with continued T1S-CL mismatch and elevated cSVA.

show abstract

“…They evaluated and compared the post-op cervical sagittal alignment in patients with thoracic and thoracolumbar Scheuermann's kyphosis. They found that the cervical lordosis increased in patients with thoracolumbar Scheuermann's kyphosis, whereas the patients with thoracic Scheuermann's kyphosis had a decrease in their cervical lordosis [20].…”

Section: Discussionmentioning

confidence: 99%