Study Of The Cervical Sagittal Alignment Of Adolescent Idiopathic Scoliosis

Objectives:Idiopathic scoliosis is a common neurological skeletal muscle disease in adolescent people, it can cause a three-dimensional shape of the spine deformity,affecting the health-related quality of life of patients. The deformity of idiopathic scoliosis is often occurred in the thoracic and lumbar spine, and they often have a close relationship with the cervical sagittal alignment. Idiopathic scoliosis teenagers often showed cervical lordosis decrease, straightened, and even the status of kyphosis.This study was to explore the relationship of adolescent idiopathic scoliosis between cervical sagittal alignment and adolescent idiopathic scoliosis curves and the Health-related quality of life.Methods: Analysis of 59 patients with mild-to-moderate AIS to xinhua hospital rehabilitation department from February 2014 to February 2016, Cobb Angle was 10 °~ 40 °, the male 14, female 45 people, aged 12 ~ 16(12.4 + /- 1.6 years).Taking full-spine standing coronal and lateral X-ray film before rehabilitation treatment.,according to the different coronal alignment of the spine, classifying patients with AIS into four categories: thoracic scoliosis, lumbar scoliosis, single thoracic lumbar scoliosis and double thoracic lumbar scoliosis. Measuring cervical spine Angle(CSA) on lateral film:The angle between C2 and C7 vertebral tangent;The classification of cervical sagittal morphology can be divided into four types:lordosis, straighten, s-shaped and kyphosis. Use of scoliosis specialized quality of life questionnaire SRS- 22 to assessment of the quality of AIS life.Comparing the cervical sagittal curvature in different type of scoliosis and the relationship beteen AIS patients cervical sagittal curvature and the HRQo L.Results: In 59 AIS patients, 11 lordosis cases,accounting for 19%, abnormal cervical sagittal, straightened + S +kyphosis 48 cases, accounting for 81%; In AIS cervical sagittal plane abnormal, 29 kyphosis cases, accounting for 59%.2.There exists significant difference between Cervical sagittal morphology and scoliosis type in AIS(F = 6.852, p = 0.048 < 0.05).3. The average cervical spine angle of all the AIS patients is 17 ° + /- 12.1 °. Curves between double thoracic lumbar and lumbar groups AIS patients with cervical spine angle is obvious difference(p = 0.021 < 0.05),the cervical spine angle of lumbar curve type patients is larger. No significant differences between the others.4. AIS patients with cevicall sagittal morphology exists obvious difference between the sexes(F = 4.897, p = 0.031 < 0.05), cervical spine angle exists obvious difference(p = 0.033 < 0.05), the male AIS patients with cervical spine angle is larger.5.In AIS patients,there is no significant correlation between the cervical spine angle and function activities, pain two dimension score of SRS- 22 questionnaire(p > 0.05),and mental health and self image are significant correlation with the cervical spine angle.(p = 0.000 < 0.05).6. In different type of AIS patients SRS- 22 questionnaire in each dimension score,the function activities, pain dimension score of the thoracic scoliosis and lumbar is a bit higher than single thoracic lumbar, double thoracic lumba type;The self-image dimension scores of thoracic scoliosis, single thoracic lumbar, double thoracic lumba type is slightly higher;The mental health dimension score of thoracic scoliosis type is slightly higher than the other three types; But there is statistical difference in function activities, pain, mental health, self-image four dimensions of score between groups(p > 0.05).7.There is no difference in function activities, pain, mental health, self-image dimensions score of SRS- 22 in different curves AIS groups(p > 0.05).Conclusion: This study found that the cervical sagittal curvature of mild-to-moderate AIS is abnormal,accounting for 81%, among them the occurring rate of the kyphosis is 59%; The cervical sagittal curvature of different curves AIS patients is not the same;Gender is a influence factors of AIS patients to cervical sagittal curvature; Although the spine curves type of AIS patients is different, but it is not does not affect on the quality of life of AIS patients. The degree of cervical spine deformity is a factors influence on the quality of life of AIS patients.