Early postoperative T1 slope is associated with 2-year cervical sagittal malalignment in Lenke 1-2 AIS with thoracic lordosis.
Low postoperative T1 slope strongly linked to cervical sagittal malalignment after scoliosis surgery
Early postoperative T1 slope is associated with 2-year cervical sagittal malalignment in Lenke 1-2 AIS with thoracic lordosis.
To investigate postoperative cervicothoracic sagittal alignment changes in adolescent idiopathic scoliosis (adolescent idiopathic scoliosis) patients with thoracic lordosis and to identify radiographic predictors of cervical sagittal malalignment (cervical sagittal malalignment).
This retrospective cohort study included 72 patients with Lenke type 1 or 2 adolescent idiopathic scoliosis with thoracic lordosis (T5-12 angle ≤ 0°) who underwent posterior spinal fusion.
T1 slope 7° or less nearly 7 times the risk of neck malalignment
Cervical sagittal malalignment was observed in 30 patients (41.7%) at 2Y.
Multivariable logistic regression analysis demonstrated that a lower T1 slope at 1 M was independently associated with cervical sagittal malalignment (OR 0.87, 95% CI 0.78-0.96, p = 0.01).
ROC analysis showed that T1 slope predicted cervical sagittal malalignment with an area under the curve (AUC) of 0.76.
The optimal cutoff value was 7°, with a sensitivity of 73% and a specificity of 76%.
In adolescent idiopathic scoliosis patients with thoracic lordosis, a low postoperative T1 slope was strongly associated with the development of cervical sagittal malalignment.
A T1 slope ≤ 7° at 1 month postoperatively predicted cervical sagittal malalignment at 2 years with moderate accuracy.
Achieving sufficient proximal thoracic kyphosis to maintain an adequate T1 slope may be important for preventing postoperative cervical sagittal malalignment.