Sagittal Spinopelvic Parameters in Scheuermann's Kyphosis: A Preliminary Study

Abstract

Sagittal pelvic alignment in patients with SK is not different from that in normal subjects. Furthermore, in SK thoracic kyphosis did not correlate with any distal region of the spine (lumbar or pelvic). Further understanding of the relationship between sagittal spinopelvic alignment in various conditions causing spinal deformity will lead to better treatment of these conditions.

Alinhamento do plano sagital e resultados funcionais após cirurgia para a cifose de Scheuermann

“…These are consistent with the previous reports by Mac-Thiong et al, 18 who described average values of PI, PT and SS as 49°, 8°and 41°r espectively, for normal children and adolescents. These observations are consistent with those of the study published by Cahill et al, 19 who evaluated the differences in spinopelvic parameters among patients with SK and unaffected normal controls, allowing us to conclude that there was no statistically significant difference in the pelvic parameters. Therefore, this suggests that SK is not driven by an inherent problem in the pelvic anatomy resulting in abnormal mechanics in the thoracic or thoracolumbar spine with subsequent secondary vertebral wedging, but rather that the anatomic changes observed at the apex of the deformity in SK are in fact the primary pathologic process.…”

“…Therefore, this suggests that SK is not driven by an inherent problem in the pelvic anatomy resulting in abnormal mechanics in the thoracic or thoracolumbar spine with subsequent secondary vertebral wedging, but rather that the anatomic changes observed at the apex of the deformity in SK are in fact the primary pathologic process. 19 The postoperative SB is an important predictor of functional results when depicting the muscular forces acting on the spine and the associated energy spent. 20 In the present study, the mean values of the SB remained within the normal range before and after surgery, which was also described by Guler et al 21 after surgical correction of SK.…”

“…Estes são consistentes com os relatórios anteriores de Mac-Thiong et al, 18 em que os valores médios da PI, PT e SS foram de 49°, 8°e 41°, respecitvamente, para crianças e adolescentes normais. Essas observações são consistentes com o estudo publicado por Cahill et al, 19 que avaliaram as diferenças nos parâmetros pélvicos entre pacientes com SK e controles normais não afetados, o que permitiu concluir que não houve diferença estatisticamente significativa nos parâmetros pélvicos. Portanto, isso sugere que a SK não é impulsionada por um problema inerente de anatomia pélvica que resulta em mecânica anormal na coluna torácica ou toracolombar com posterior encolhimento vertebral secundário, mas que as alterações anatômicas vistas no ápice da deformidade na SK são de fato o processo patológico primário.…”

“…Portanto, isso sugere que a SK não é impulsionada por um problema inerente de anatomia pélvica que resulta em mecânica anormal na coluna torácica ou toracolombar com posterior encolhimento vertebral secundário, mas que as alterações anatômicas vistas no ápice da deformidade na SK são de fato o processo patológico primário. 19 O SB pós-operatório é um importante preditor de resultados funcionais ao retratar as forças musculares que agem na coluna vertebral e a energia associada gasta. 20 Neste estudo, os valores médios do SB permaneceram dentro da faixa normal antes e depois da cirurgia, que também foi descrita por Guler et al 21 após a correção cirúrgica da SK.…”

Sagittal Spinal and Pelvic Parameters in Patients With Scheuermann's Disease: A Preliminary Study

“…Different studies about Scheuermann kyphosis question these relationships especially between PI and LL, whereas these 2 parameters have been shown to be key factors to account for in achieving good clinical results. 18,23 On the other hand, Ashraf et al 3 and Cahill et al 24 showed in their studies that LL is driven by hyperkyphosis elsewhere. The latter suggest that the lumbar spine serves as a sagittal buffer between the pelvis and thoracic spine.…”