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Global sagittal alignment after surgery of right thoracic idiopathic scoliosis in adolescents and adults with and without thoracic hypokyphosis

Article dans une revue avec comité de lecture
Author
YEUNG, Kwong Hang
1031611 Chinese University of Hong Kong
MAN, Gene Chi Wai
1031611 Chinese University of Hong Kong
SKALLI, Wafa
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
HU, Zongshan
1031611 Chinese University of Hong Kong
HUNG, Vivian Wing Yin
1031611 Chinese University of Hong Kong
HUNG, Alec Lik Hang
1031611 Chinese University of Hong Kong
LAM, Tsz Ping
1031611 Chinese University of Hong Kong
NG, Bobby Kin Wah
1031611 Chinese University of Hong Kong
CHENG, Jack Chun Yiu
VERGARI, Claudio
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
CHU, Winnie Chiu Wing
1031611 Chinese University of Hong Kong

URI
http://hdl.handle.net/10985/20025
DOI
10.1038/s41598-021-85782-6
Date
2021
Journal
Scientific Reports

Abstract

AbstractThis study aimed to characterize global sagittal alignment in adolescent idiopathic scoliosis (AIS) with normal kyphosis (NTK, kyphosis > 10°) and with thoracic hypokyphosis (THK, kyphosis < 10°), before and after posterior spinal fusion, and compare them with asymptomatic controls. 27 AIS girls and young adults with right thoracic curves were included (seventeen with age ≤ 18 years, then age > 21). Biplanar radiographies were acquired at baseline, immediate post-operatively, 1-year and 2-year follow-up, and 3D reconstruction of the spine and pelvis was performed. NTK and THK showed different global sagittal alignment, as well as differences compared to controls. AIS with THK at baseline had higher SVA/SFD (2.0 ± 2.9 vs − 0.4 ± 1.9; P < 0.05) and OD-HA (0.2 ± 1.4° vs − 1.3 ± 1.6°; P < 0.05) than controls, indicating that THK had compensated balance with unusual forward leaning posture. Immediately post-operation, SVA/SFD remained high (1.3 ± 3.0) while OD-HA reversed (− 1.2 ± 1.7°), indicating that THK patients had found partially compensated balance. After 2-yeas, both SVA/SFD (− 1.3 ± 2.1) and OD-HA (− 1.4 ± 0.9°) were normalized. The changes in global sagittal alignment and mechanism of balance are different in AIS with or without THK. As the head plays a critical role on balance during immediate and delayed post-operation, OD-HA can be complementary parameter for assessing global balance during post-operative follow-up of AIS patients with THK.

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