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. 2013 Nov;22(11):2414-20.
doi: 10.1007/s00586-013-2852-z. Epub 2013 Jun 17.

Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis

Jean-Luc Clément  1 , Anne Geoffray, Fatima Yagoubi, Edouard Chau, Federico Solla, Ioana Oborocianu, Virginie Rampal
Affiliations

Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis

Jean-Luc Clément et al. Eur Spine J. 2013 Nov.

Abstract

Purpose: Sagittal spine and pelvic alignment of adolescent idiopathic scoliosis (AIS) is poorly described in the literature. It generally reports the sagittal alignment with regard to the type of curve and never correlated to the thoracic kyphosis. The objective of this study is to investigate the relationship between thoracic kyphosis, lumbar lordosis and sagittal pelvic parameters in thoracic AIS.

Methods: Spinal and pelvic sagittal parameters were evaluated on lateral radiographs of 86 patients with thoracic AIS; patients were separated into hypokyphosis group (n = 42) and normokyphosis group (n = 44). Results were statistically analyzed. The lumbar lordosis was lower in the hypokyphosis group, due to the low proximal lordosis. The thoracic kyphosis was not correlated with any pelvic parameters but with the proximal lordosis. The pelvic incidence was correlated with sacral slope, pelvic tilt, lumbar lordosis and highly correlated with distal lumbar lordosis in the two groups. There was a significant linear regression between thoracic kyphosis and proximal lordosis and between pelvic incidence and distal lordosis.

Conclusions: We can consider that the proximal part of the lordosis depends on the thoracic kyphosis and the distal part depends on the pelvic incidence. The hypokyphosis in AIS is independent of the pelvic parameters and could be described as a structural parameter, characteristic of the scoliotic deformity.

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Figures

Fig. 1
Fig. 1
Sagittal pelvic and spine parameters. The hip axis is located midway between the centre of the femoral heads. Pelvic Incidence (PI) is always equal to the sum of sacral slope (SS) and pelvic tilt (PT). Lumbar Lordosis (LL) measured between T12 and S1, is divided in the Proximal Lumbar Lordosis (PLL) under the apex of the lordosis and Distal Lumbar Lordosis (DLL) below the apex. SS is equivalent to DLL. Thoracic kyphosis (TK) is measured between T4 and T12
Fig. 2
Fig. 2
Linear regression plots of Thoracic kyphosis (TK) in function of a lumbar lordosis (LL) and, b distal lumbar lordosis (DLL) and c proximal lumbar lordosis (PLL)
Fig. 3
Fig. 3
Linear regression plots of Pelvic incidence (PI) in function of a lumbar lordosis (LL) and, b distal lumbar lordosis (DLL) and c proximal lumbar lordosis (PLL)
See this image and copyright information in PMC

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