ISSN: 1859 - 2872
Shoulder and neck balance in adolescent idiopathic scoliosis: Correlation between clinical appearance and radiography
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Abstract
Objective: This study aimed to define parameters to assess shoulder and neck balance in adolescent idiopathic scoliosis in correlation between clinical appearance and radiography. Subject and method: This observational study recruited 50 patients with adolescent idiopathic scoliosis who were 12 to 18 years of age with Cobb angle > 10°. Based on Pearson correlation coefficient, radiographic parameters such as coracoid height difference (CHD), clavicle rib intersection distance (CRID), clavicle angle (CA), clavicle chest cage angle difference (CCAD), and T1 tilt angle were evaluated in correlation with clinical shoulder and neck balance by difference of inner shoulder height (SHi), difference of outer shoulder height (SHo), and neck tilt angle. Result: SHi was moderately correlated with T1 tilt angle (r [hereafter] = 0.45), CA (0.47), and CHD (0.57), high-moderately correlated with CRID (0.64), very-highly correlated with CCAD (0.84). SHo was moderately correlated with T1 tilt angle (0.43), highly correlated with CHD (0.60), CA (0.63), and CRID (0.72), and very-highly correlated with CCAD (0.89). T1 tilt angle was high-moderately correlated with neck tilt angle (0.76). The correlation indices between clinical and radiographic shoulder and neck balance according to sex, type of main curve did not change significantly. Conclusion: There was a very high correlation between SHo (shoulder tilt) and CCAD (r = 0.89); the correlation between SHo and CA was high-moderate (r = 0.63) but CA is easier than CCAD to evaluate on intraoperative radiographs. On the other hand, T1 tilt angle, which is the easiest radiographic parameter to evaluate intraoperatively, had a high-moderate correlation with neck tilt angle (r = 0.76) but a moderate correlation with SHo (r = 0.43).
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References
2. Yang S, Feuchtbaum E, Werner BC et al (2012) Does anterior shoulder balance in adolescent idiopathic scoliosis correlate with posterior shoulder balance clinically and radiographically?. Eur Spine J 21: 1978-1983.
3. Yagi M, Takemitsu M, Machida M (2013) Chest cage angle difference and rotation of main thoracic curve are independent risk factors of postoperative shoulder imbalance in surgically treated patients with adolescent idiopathic scoliosis. Spine 38(19): 1209-1215.
4. Kwan MK, Wong KA, Lee CK, Chan CYW (2016) Is neck tilt and shoulder imbalance the same phenomenon? A prospective analysis of 89 adolescent idiopathic scoliosis patients (Lenke type 1 and 2). Eur Spine J 25(2): 401-408.
5. Zuckerman SL, Cerpa M, Baum GR et al (2021) Surgeons lack of agreement on determining preoperative radiographic and clinical shoulder balance in adolescent and adult idiopathic scoliosis patients. Eur Spine J 30: 661-667.
6. Bago J, Carrera L, March B, Villanueva C (1996), Four radiological measures to estimate shoulder balance in scoliosis. J Pediatr Orthop B 5(1): 31-34.
7. Akel I, Pekmezci M, Hayran M, Genc Y et al (2008) Evaluation of shoulder balance in the normal adolescent population and its correlation with radiological parameters. Eur Spine J 17(3): 348-354.
8. Luhmann SJ, Sucato DJ, Johnston CE, Richards BS, et al (2016) Radiographic Assessment of Shoulder Position in 619 Idiopathic Scoliosis Patients: Can T1 Tilt Be Used as an Intraoperative Proxy to Determine Postoperative Shoulder Balance?. J Pediatr Orthop 36(7): 691-694.
9. Ono T, Bastrom TP, Newton PO (2012) Defining 2 components of shoulder imbalance: Clavicle tilt and trapezial prominence. Spine 37: 1511-1516.
10. Yang Y, Yang M, Yang Z, Chen K, et al (2019), Postoperative neck tilt in Lenke 1 and 2 AIS patients after correction surgery: A novel predictive index. BMC Musculoskelet Disord 20(1): 405.
11. Kuklo TR, Lenke LG, Graham EJ, Won DS, et al (2002) Correlation of radiographic, clinical, and patient assessment of shoulder balance following Fusion versus nonfusion of the proximal thoracic curve in adolescent idiopathic scoliosis. Spine 27(18): 2013-2020.
12. Chiu CK, Chan CYW, Tan PH, Goh SH, et al (2020), Conformity and changes in the radiological neck and shoulder balance parameters throughout 3 years follow-up period: Do They Remain the Same?. Spine 45(6): 319-328.
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