title: Sagittal balance in scoliosis associated with Marfan syndrome: a stereoradiographic three-dimensional analysis.
abstract: OBJECTIVE
  Marfan syndrome (MFS) is a genetic disease often marked by the presence of scoliosis. There is no three-dimensional analysis of the deformity in the literature. Our aim was to determine what kind of sagittal balance defines scoliosis associated with MFS, namely a flexion deformity, as it is in scoliosis associated with Chiari I or an extension deformity, as in adolescent idiopathic scoliosis (AIS). To address this issue, we compared the presence or absence of a thoracic scoliosis with the presence or absence of a segment in extension in the thoracic spine.
  
  
  METHODS
  In our series, 30 patients diagnosed with Marfan syndrome were prospectively included. In each patient, personalized three-dimensional reconstruction from T1 to L5 of the spine was made using stereoradiography. The patients were first separated based on the presence or absence of thoracic scoliosis, in order to compare this with the presence or absence of a segment in extension in the thoracic spine. They were then classified into two groups based on the presence or absence of the segment in extension (meaning containing negative values of inter-vertebral sagittal rotation) in the thoracic spine.
  
  
  RESULTS
  Among scoliotic patients with a thoracic scoliosis (17 cases), there were 13 (76.5% cases) with a segment in extension in the thoracic spine and 4 with no segment in extension.
  
  
  CONCLUSIONS
  Our results showed that scoliosis associated with MFS is somehow original, demonstrating a sagittal balance in extension (as AIS) in about 80% of thoracic curves, but without this characteristic feature in about 20%.
authors.affiliation: Service de Chirurgie Orthopédique Infantile, Hôpital d'Enfants de la Timone, 245 Rue St Pierre, 13385, Marseille Cedex 5, France, yann.glard@gmail.com.
authors.forename: Yann
authors.initials: Y
authors.lastname: Glard
authors.forename: Vincent
authors.initials: V
authors.lastname: Pomero
authors.forename: Patrick
authors.initials: P
authors.lastname: Collignon
authors.forename: Wafa
authors.initials: W
authors.lastname: Skalli
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Jouve
authors.forename: Gérard
authors.initials: G
authors.lastname: Bollini