Adolescent idiopathic scoliosis (AIS) causes vertebral wedging, but associated factors and the impact of vertebral wedging are still unknown. We investigated associated factors and effects of vertebral wedging in AIS using computed tomography (CT).
Preoperative patients (n = 245) with Lenke types-1 and 2 were included. Vertebral wedging, lordosis, and rotation of the apical vertebra were measured by preoperative CT. Skeletal maturity and radiographic global alignment parameters were evaluated. Multiple regression analysis was performed on associated factors for vertebral wedging. Side-bending radiographs were evaluated using multiple regression analysis to calculate the percentage of reduction of Cobb angles to determine curve flexibility.
The mean vertebral wedging angle was 6.8 ± 3.1°. Vertebral wedging angle was positively correlated with proximal thoracic (r = 0.40), main thoracic (r = 0.54), and thoracolumbar/lumbar curves (r = 0.38). By multiple regression, the central sacral vertical line (p = 0.039), sagittal vertical axis (p = 0.049), main thoracic curve (p = 0.008), and thoracolumbar/lumbar curve (p = 0.001) were significant factors for vertebral wedging. In traction and side-bending radiographs there were positive correlations between curve rigidity and the vertebral wedging angle (r = 0.60, r = 0.59, respectively). By multiple regression, thoracic kyphosis (p < 0.001), lumbar lordosis (p = 0.013), sacral slope (p = 0.006), vertebral wedging angle (p = 0.003), and vertebral rotation (p = 0.002) were significant factors for curve flexibility.
Vertebral wedging angle was found to be highly correlated to coronal Cobb angle, with larger vertebral wedging indicating less flexibility.
Abbreviations:AIS (adolescent idiopathic scoliosis), MRI (magnetic resonance imaging), CT (computed tomography), ICCs (interclass correlation coefficients), C7-CSVL (C7 coronal plumbline from the central sacral vertical line), SVA (sagittal vertical axis), TK (thoracic kyphosis), LL (lumbar lordosis), SS (sacral slope), PI (pelvic incidence), FI (flexibility index)
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Published online: March 16, 2023
Accepted: March 2, 2023
Received in revised form: February 22, 2023
Received: January 13, 2023
Publication stageIn Press Corrected Proof
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