Radiographic Indicators Of Cervical Spine And Their Correlation To Neck Pain In Female Adolescent Idiopathic Scoliosis Patients

[Objectives]:1. To investigate the correlation of cervical vertebrae maturation (CVM), Fishman skeletal maturity indicators (SMI) or the Risser sign. To verify CVM, as an additional indicators of Risser sign, can be applied to evaluate the growth situation female adolescent idiopathic scoliosis (AIS) patients.2. To investigate the characteristics of cervical vertebras of female AIS patients with quantitative cervical vertebrae maturation indicators. Figure out the difference of these indicators between female AIS patients and age-matched normal females.3. To investigate the difference non-specific neck pain between adolescent idiopathic scoliosis patients and non-scoliosis patients. Find out the relation between cervical imaging characteristics and non-specific neck pain.[Methods]:1. Lateral spine X full-length radiograph and left hand wrist radiographs of 67 AIS female patients were measured by Baccetti method and Fishman method respectively. The results were analysis by Spearman correlation with Risser sign and the chronology age, menarche time etc.2. The parameters of C2, C3, and C4 were measured on lateral spine full-length radiographs of 49 female AIS patients (Research Group, RG) and 49 normal females (Control Group, CG) aged from 10 to 16 years. T-test was used to compare the difference of these indicators in two groups. The indicators in each group were analyzed by AVONA according to the age and CVM.3. 64 female AIS patients (Scoliosis Group, SG) and 64 age-matched normal female (Control Group, CG) accepted the NPAD research. Lateral cervical spine radiographies from patients who complained about neck pain had been measured. The results of cervical lordosis (C2-C7), cervical arc chord distance and other parameters were compared.[Results]:1. CVM and SMI or Risser sign are related closely. (r = 0.806, 0.783, P <0.01), while the r value is 0.708 between Risser sign and SMI. CVM is related less with menarche and chronological age. When Risser sign is 0-1, CVM have a higher correlation (r = 0.523, P <0.01) with SMI than the others do.2. The anterior vertebral height AH3 of C3, the central height H4 of C4 and angle 2 , which is formatted by bottom vertex and the horizontal line of C2 increase according to age and CVM in CG. However, in RG, AH3 and H4 increase more obviously than other indicators. There is a difference between CG and RG on these indicators while age range from 10 to 13. After 14, the difference becomes ignorable.3. The incidence rate of non-specific neck pain in the scoliosis group is about 43.75% while 31.25% in the normal control group. There exists significant difference in cervical physical lordosis , rotation arc distance, T5-T12. P=0.028, 0.009, 0.036. The difference in L1-S1, T11-L2, and CSVL are little.[Conclusion]:1. Cervical vertebrae maturation (CVM) is convenience. Patients need not the extra radiography to evaluate the growth. The closely relationship between CVM and SMI implies it is a valid indicator of skeletal evaluation and can be used as a helpful supplementary indicator to Risser Sign.2. The cervical morphological change of female AIS patient with the spine growth more closely than with the age. The cervical vertebrae changed differently between female AIS patients and normal age-matched females. It may related with the abnormal growth in AIS. With the maturation, the difference becomes less.3. Female idiopathic Scoliosis patients with neck pain have physiological lordosis reduction, which may cause by thoracic kyphosis reduction. Long-term Follow-up may be the prominent reduction of cervical physiological curvature of the symptoms.