title: The sagittal alignment of the cervical spine in adolescent idiopathic scoliosis.
abstract: To assess the sagittal orientation of the cervical and thoracolumbar spine, 38 adolescents with idiopathic scoliosis were studied. The C7 plumb line and Cobb angles from C2-6, T1-12, and L1-S1 were measured on preoperative films. Lateral radiographs with > 1-year follow-up after surgical correction were available for the same measurements in 28 patients. The preoperative curve from C2-6 was 6 +/- 11 degrees of kyphosis. There was a significant correlation between the loss of thoracic kyphosis and the development of cervical kyphosis for the entire group preoperatively (p = 0.009). Postoperatively, cervical kyphosis increased to 11 +/- 9 degrees at 1-year follow-up (p = 0.05). There was no progression of cervical kyphosis in patients with "thoracic hypokyphosis" (kyphosis < 20 degrees). Cervical kyphosis increased in patients with "normal" thoracic kyphosis (20-40 degrees) and in patients with hyperkyphosis (kyphosis > 40 degrees) after surgery, despite preservation of thoracolumbar sagittal contour. There were no significant differences between the sagittal contour of patients treated with Cotrel-Dubousset or Harrington instrumentation.
authors.affiliation: Section of Orthopaedic Surgery, University of Michigan Hospitals, Ann Arbor 48109, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Hilibrand
authors.forename: D A
authors.initials: DA
authors.lastname: Tannenbaum
authors.forename: G P
authors.initials: GP
authors.lastname: Graziano
authors.forename: R T
authors.initials: RT
authors.lastname: Loder
authors.forename: R N
authors.initials: RN
authors.lastname: Hensinger
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007738:Kyphosis / Q000473:pathology* / Q000601:surgery; D012600:Scoliosis / Q000473:pathology* / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods