title: Cervical spine sagittal alignment variations following posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis.
abstract: The aim of this study is to quantify the changes in the sagittal alignment of the cervical spine in patients with adolescent idiopathic scoliosis following posterior spinal fusion. Patients eligible for study inclusion included those with a diagnosis of mainly thoracic adolescent idiopathic scoliosis treated by means of posterior multisegmented hook and screw instrumentation. Pre and post-operative anterior-posterior and lateral radiographs of the entire spine were reviewed to assess the changes of cervical sagittal alignment. Thirty-two patients (3 boys, 29 girls) met the inclusion criteria for the study. The average pre-operative cervical sagittal alignment (CSA) was 4.0° ± 12.3° (range -30° to 40°) of lordosis. Postoperatively, the average CSA was 1.7° ± 11.4° (range -24° to 30°). After surgery, it was less than 20° in 27 patients (84.4%) and between 20° and 40° in 5 patients (15.6%). The results of the present study suggest that even if rod precontouring is performed and postoperative thoracic sagittal alignment is restored, improved or remains unchanged after significant correction of the deformity on the frontal plane, the inherent rigidity of the cervical spine limits changes in the CSA as the cervical spine becomes rigid over time.
authors.affiliation: Pediatric Orthopaedic Service, Department of Child and Adolescent, University of Geneva Hospitals, 6, Rue Willy Donzé, 1211 Geneva 14, Switzerland. canavese_federico@yahoo.fr
authors.forename: Federico
authors.initials: F
authors.lastname: Canavese
authors.forename: Katia
authors.initials: K
authors.lastname: Turcot
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Rosa
authors.forename: Geraldo
authors.initials: G
authors.lastname: de Coulon
authors.forename: André
authors.initials: A
authors.lastname: Kaelin
mesh_terms: D000293:Adolescent; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D013131:Spine / Q000000981:diagnostic imaging; D013904:Thoracic Vertebrae / Q000601:surgery