The radiographic characteristics of congenital scoliosis associated with Sprengel′s deformity

English Keywords:Congenital scoliosis  Sprengel′s deformity  Radiographic characteristics  Shoulder imbalance

English Abstract:

  【Abstract】 Objectives: To investigate the radiographic features of congenital scoliosis (CS) associated with Sprengel′s deformity, and to assess the correlation between Sprengel′s deformity and shoulder imbalance in this cohort. Methods: Complete radiographic data of twenty-four CS patients combined with Sprengel′s deformity that were diagnosed with spinal deformity in our center from January 2000 to October 2015 were retrospectively reviewed. There were 11 males and 13 females, and the average age was 11.8±6.0 years(2-31 years). The following parameters were measured on standing whole spinal X-rays: curve pattern, Cobb angle, apical vertebrae, upper and lower end vertebrae, shoulder imbalance, location of Sprengel′s deformity, and levels of hemivertebrae. Spearman correlation analysis was performed to analyze the relationship between shoulder imbalance and the radiographic characteristics. Results: The cervicothoracic or thoracic scoliosis was observed in all patients, and the average Cobb angle was 49.5°±23.3°. The ranges of apical vertebrae were T1-T11. 16 patients were with single or multiple hemivertebrae deformity, which located at T4 or upper levels in 10(62.5%) patients and at T5 or lower levels in 6 patients(37.5%). Rib abnormalities was found in 15 patients, which located on the concave side in 9 patients, convex side in 3 patients, and both sides in 3 patients. The Sprengel′s deformity occurred on convex side of the scoliosis in 15 patients(62.5%), on concave side in 7 patients(29.2%) and on both sides in 2 patients(8.3%), and all showed shoulder of convex side higher than concave side. Of the 7 patients with concave Sprengel′s deformity, the convex shoulder was higher in 2 patients and lower in 5 patients when compared with the concave shoulder. The value of shoulder imbalance was 15.7±21.0mm, which according to the Spearman correlation analysis had no significant correlation with the Cobb angle, apical vertebrae location and upper and lower end vertebrae locations and other radiographic parameters(P>0.05). Conclusions: The cervicothoracic or thoracic scoliosis were the most common curve pattern in CS combined with Sprengel′s deformity. Hemivertebrae were predominantly seen at T4 or upper levels. The Sprengel′s deformity and rib abnormities were more common on convex side of the scoliosis, though no significant correlation was found between shoulder imbalance and the radiographic parameters.