Abstract
Background
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).
Methods
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.
Results
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.
Conclusions
Vertebral wedging angle was found to be highly correlated to coronal Cobb angle, with
larger vertebral wedging indicating less flexibility.
Keywords
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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 16, 2023
Accepted:
March 2,
2023
Received in revised form:
February 22,
2023
Received:
January 13,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
