Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis

Clément, Jean-Luc; Geoffray, A.; Yagoubi, Fatima; Chau, E.; Solla, Federico; Oborocianu, Ioana; Rampal, Virginie

doi:10.1007/s00586-013-2852-z

Cited by 68 publications

(39 citation statements)

References 22 publications

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“…In these studies, the patients with scoliosis had a moderate to severe thoracic curve (mean Cobb angles varied between 35° and 60°); however, Schlösser et al [15] included only mild curves (Cobb angle 20° or lower) and found similar results (PI for thoracic AIS patients: 47°, PI for (thoraco)lumbar AIS patients: 42° and PI for controls: 43°; without significant differences). It has been described that the PI in AIS is higher as compared to the non-scoliotic controls; however, others described no significant differences between AIS patients and non-scoliotic adolescents [1,10,13,19,21,27,28]. Slight PI differences among studies could be explained by the differences in age, since the PI increases with age, but also to the inaccuracy of the 2D method [16,29].…”

Section: Discussionmentioning

confidence: 95%

“…Most studies described a relation between the PI and the (thoraco)lumbar sagittal alignment, but not between the PI and the thoracic alignment [10,13,17,19,21,27,30]. This suggests that the PI influences the (thoraco) lumbar region of the spine, but the thoracic part is independent of the PI.…”

Section: Discussionmentioning

confidence: 99%

“…Several other authors described the spino-pelvic balance in normal children and adolescents during growth and in patients with different pathologies [1,[10][11][12][13][14][15][16][17][18][19][20][21]. Dickson et al [5] described that differences in the sagittal plane (reversal of the normal thoracic kyphosis) during growth could initiate a progressive idiopathic scoliosis.…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

“…Dickson et al [5] described that differences in the sagittal plane (reversal of the normal thoracic kyphosis) during growth could initiate a progressive idiopathic scoliosis. Moreover, previous authors suggested a link between the spino-pelvic morphology and spinal deformities in the sagittal plane [1,[10][11][12][13][14][15][16][17][18][19][20][21]. Most of the previous studies obtained two-dimensional (2D) referential values using standing lateral radiographs that could lead to a deviation from the true sagittal plane and to a certain degree of distortion of the image.…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

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Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls

et al. 2018

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Purpose The pelvic incidence (PI) is used to describe the sagittal spino-pelvic alignment. In previous studies, radiographs were used, leading to less accuracy in establishing the three-dimensional (3D) spino-pelvic parameters. The purpose of this study is to analyze the differences in the 3D sagittal spino-pelvic alignment in adolescent idiopathic scoliosis (AIS) subjects and non-scoliotic controls. Methods Thirty-seven female AIS patients that underwent preoperative supine low-dose computed tomography imaging of the spine, hips and pelvis as part of their general workup were included and compared to 44 non-scoliotic age-matched female controls. A previously validated computerized method was used to measure the PI in 3D, as the angle between the line orthogonal to the inclination of the sacral endplate and the line connecting the center of the sacral endplate with the hip axis. Results The PI was on average 46.8° ± 12.4° in AIS patients and 41.3° ± 11.4° in controls (p = 0.025), with a higher PI in Lenke type 5 curves (50.6° ± 16.2°) as compared to controls (p = 0.042), whereas the Lenke type 1 curves (45.9° ± 12.2°) did not differ from controls (p = 0.141). Conclusion Lenke type 5 curves show a significantly higher PI than controls, whereas the Lenke type 1 curves did not differ from controls. This suggests a role of pelvic morphology and spino-pelvic alignment in the pathogenesis of idiopathic scoliosis. Further longitudinal studies should explore the exact role of the PI in the initiation and progression of different AIS types.Graphical abstract These slides can be retrieved under Electronic Supplementary Material.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

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Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls

et al. 2018

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“…Modern classification systems are based on coronal (AP or PA), sagittal and dynamic radiographs [9], and new insights regarding sagittal alignment of spinal deformities require a full spine lateral radiograph with the hips visible [10,11]. According to a prospective study by Horton et al [12], the best position for taking these radiographs is with the hands on the clavicles.…”

Section: Supporting Empirical Evidencementioning

confidence: 99%

Optimal surgical care for adolescent idiopathic scoliosis: an international consensus

et al. 2014

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Purpose The surgical management of adolescent idiopathic scoliosis (AIS) has seen many developments in the last two decades. Little high-level evidence is available to support these changes and guide treatment. This study aimed to identify optimal operative care for adolescents with AIS curves between 40°and 90°Cobb angle. Methods From July 2012 to April 2013, the AOSpine Knowledge Forum Deformity performed a modified Delphi survey where current expert opinion from 48 experienced deformity surgeons, representing 29 diverse countries, was gathered. Four rounds were performed: three web-based surveys and a final face-to-face meeting. Consensus was achieved with C70 % agreement. Data were analyzed qualitatively and quantitatively.Results Consensus of what constitutes optimal care was reached on greater than 60 aspects including: preoperative radiographs; posterior as opposed to anterior (endoscopic) surgical approaches; use of intraoperative spinal cord monitoring; use of local autologous bone (not iliac crest) for grafts; use of thoracic and lumbar pedicle screws; use of titanium anchor points; implant density of \80 % for 40°-70°curves; and aspects of postoperative care. Variability in practice patterns was found where there was no consensus. In addition, there was consensus on what does not constitute optimal care, including: routine pre-and intraoperative traction; routine anterior release; use of bone morphogenetic proteins; and routine postoperative CT scanning. operative care for adolescents with AIS. In the absence of current high-level evidence, at present, these expert opinion findings will aid health care providers worldwide define appropriate care in their regions. Areas with no consensus provide excellent insight and priorities for future research.

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The Modern and Fossil Hominoid Spinal Ontogeny

Martelli

2019

Spinal Evolution

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Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis

Cited by 68 publications

References 22 publications

Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls

Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls

Optimal surgical care for adolescent idiopathic scoliosis: an international consensus

The Modern and Fossil Hominoid Spinal Ontogeny

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