Comparison of the sagittal morphology in adult idiopathic scoliosis with age-matched healthy adults in Chinese Han population

English Keywords:Adult idiopathic scoliosis  Pelvic morphology  Sagittal balance

English Abstract:

  【Abstract】 Objectives: To determine the difference of the sagittal morphology in adult idiopathic scoliosis(IS) with age-matched healthy adults in Chinese Han population. Methods: 151 adult patients with idiopathic scoliosis(IS) and 65 healthy age-matched adults were recruited consecutively. Within the 151 patients, there were 25 males and 126 females. The average age of the IS patients was 26.4±7.1 years. The average Cobb angle of the main curve was 39.5°±16.4°(16°-102°). There were 41 cases with single thoracic scoliosis, 11 with double thoracic scoliosis, 28 with double major scoliosis, 15 with thoracolumbar scoliosis, 3 with triple major scoliosis and 53 with lumbar scoliosis. All the parameters were measured on the standing posteroanterior and lateral radiographs. The measured sagittal parameters included thoracic kyphosis(TK), lumbar lordosis(LL), pelvic incidence(PI), sacrum slope(SS), and pelvic tilt(PT). The parameters were compared between IS adults and healthy adults. Analysis of variance was used to compare the sagittal parameters among single thoracic scoliosis group, lumbar scoliosis group and healthy adults group. The associations of all parameters were also analyzed. The correlation between 2 sagittal variables was determined via Pearson correlation coefficient(r). Results: The PI(46.3°±10.6° vs. 46.0°±9.5°, P>0.05) and LL(-53.3°±13.8° vs. -51.3°±9.0°, P>0.05) of adult idiopathic scoliosis patients were comparable with those of healthy persons. The TK(19.7°±12.9° vs. 27.8°±9.8°, P<0.05) and PT(6.4°±8.2° vs. 10.3°±6.3°, P<0.05) of adult idiopathic scoliosis patients were significant smaller than those of the healthy adults. The SS(39.8°±8.8° vs. 35.7°±7.2°, P<0.05) of adult idiopathic scoliosis patients was significant larger than that of the healthy adults. The TK values were comparable(P>0.05) between single thoracic scoliosis patients and lumbar scoliosis patients. The PI values were comparable(P>0.05) among single thoracic scoliosis patients, lumbar scoliosis patients and healthy persons. The TJK of single thoracic scoliosis patients was smaller than that of lumbar scoliosis and healthy persons(P<0.05). The LL value of single thoracic scoliosis patients was larger than that of lumbar scoliosis(P<0.05). The SS of single thoracic scoliosis patients was larger than that of healthy persons(P<0.05). The PT of lumbar scoliosis patients was smaller than that of healthy persons(P<0.05). The TK was found to be strongly correlated with LL in all the three groups(P<0.05). The LL was associated with PI and SS in all the three groups(P<0.05). The PT was correlated with TK and LL in the single thoracic scoliosis group and lumbar scoliosis group(P<0.05), but not in the control group(P>0.05). Conclusions: Adult idiopathic scoliosis patients have flatter thoracic kyphosis and pronated pelvic compared with normal controls. Adult idiopathic scoliosis in Chinese have similar PI compared with age-matched healthy adults. The pelvic incidence has no difference between single thoracic and lumbar scoliosis group.