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Lumbar Lordosis Minus Thoracic Kyphosis

Remain Constant in Adolescent Idiopathic Scoliosis Patients Before and After Correction Surgery

Yang, Mingyuan MD; Yang, Changwei MD; Chen, Ziqiang MD; Wei, Xianzhao MD; Chen, Yuanyuan MD; Zhao, Jian MD; Shao, Jie MD; Zhu, Xiaodong MD; Li, Ming MD

doi: 10.1097/BRS.0000000000001258

Study Design. A retrospective study.

Objective. To explore the relationship between the change of lumbar lordosis (LL) and thoracic kyphosis (TK) in AIS patients after correction surgery.

Summary of Background Data. TK tends to decrease in Lenke 1 and Lenke 2 AIS patients after correction surgery using pedicle screws, with the compensation of LL decrease. We hypothesize that lumbar lordosis minus thoracic kyphosis (LL-TK) remains constant after correction surgery to achieve the sagittal balance in AIS patients.

Methods. Medical records of Lenke 1 or Lenke 2 AIS patients who received posterior correction surgery using pedicle screws in our hospital from January 2010 to January 2013 were reviewed. General characters of patients and radiological parameters were evaluated before the surgery and at two years’ follow-up. Correlation analysis between TK and LL was conducted. LL-TK and the change of LL and TK were analyzed at preoperation and final follow-up.

Results. A total of 76 Lenke 1 and Lenke 2 AIS patients were included. Both TK and LL decreased significantly after correction surgery (P = 0.019 and P = 0.040, respectively). There were significant correlations between TK and LL before and after surgery, respectively (preoperative: r = 0.234, P = 0.042; postoperative: r = 0.310, P = 0.006). Preoperative and postoperative LL-TK was 23.80° and 25.09°, respectively, and no significant difference of LL-TK was observed (P = 0.372). The same tendency was observed in the change of LL and TK, and significant correlation was also found between the change of TK and LL (r = 0.626, P = 0.002).

Conclusion. The same change of LL and TK and no significant difference in LL-TK indicated that LL-TK might be an important compensatory mechanism in keeping sagittal balance.

Level of Evidence: 4

*Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai, China

Department of Laboratory Medicine, Changhai Hospital of the Second Military Medical University, Shanghai, China.

Address correspondence and reprint requests to Changwei Yang and Ming Li; E-mail:

Received 6 August, 2015

Revised 23 August, 2015

Accepted 7 September, 2015

Mingyuan Yang, Changwei Yang, Ziqiang Chen, Xianzhao Wei contributed equally to this work.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.