Cervical spine balance: postoperative radiologic changes in adult scoliosis surgery.
OBJECTIVE
Cervical spine alignment interests appeared recently and relationships between the pelvis and the cervical spine have been reported but remain unclear. In this study, postoperative changes for cranial, cervical, lumbar and sagittal balance parameters have been measured in adult scoliosis surgery without major sagittal malalignment to appreciate the adaptation of the cervical spine.


METHODS
Twenty-nine consecutive patients with a surgical adult degenerative scoliosis treated with a T8-T11 to iliac fusion without PSO or multiple Ponte's osteotomies had preoperative and postoperative full spine EOS radiographies to measure spino-pelvic parameters. Correlation analysis between the different parameters was performed.


RESULTS
Lower cervical, lordosis, lumbar lordosis and thoracic kyphosis were increased in postoperative as no changes were observed for upper cervical lordosis. C1-C7 CL highly correlated (0.85 in preoperative and 0.87 in postoperative) with C7 slope, which highly correlated itself with global balance parameters (0.74 in preoperative and 0.71 in postoperative for CAM-PL) underlining the relationship between cervical spine alignment and global malalignment.


CONCLUSIONS
Modifications of lower CL are observed, as upper CL remains constant. If no correlation was found for LL, TK and CL changes, CL appears to be highly correlated with C7 slope, which highly correlated itself with sagittal global balance parameters. C7 slope appears as a base for CL influenced by the spine global alignment.
Spine Unit 1, Orthopedic Surgery Department, Bordeaux Pellegrin Hospital, Place Amélie Raba Léon, Bordeaux, France, boissierelouis@yahoo.fr.
Louis
L
Boissière
Jean
J
Bernard
Jean-Marc
JM
Vital
Vincent
V
Pointillart
Rémi
R
Mariey
Olivier
O
Gille
Ibrahim
I
Obeid
D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging*; D008141:Lordosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011859:Radiography; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000601:surgery