Cervicocephalic relocation test to evaluate cervical proprioception in adolescent idiopathic scoliosis.

Abstract

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine associated with disturbed postural control. Cervical proprioception participates in controlling orthostatic posture via its influence on head stabilization. We hypothesized that patients with AIS exhibit altered cervical proprioception. We conducted a case-control study to evaluate cervical proprioception using the cervicocephalic relocation test (CRT) in 30 adolescents with AIS (15.5±1.5years; Cobb 24.8°±9.5°) versus 14 non-scoliotic controls (14.6±2.0years). CRT evaluates cervical proprioception by measuring the capacity to relocate the head on the trunk after active rotation of the head in the transversal plane without visual control. Each subject performed ten right and then ten left head rotations. The CRT results were pathological in 12 AIS patients (40%). The CRT mean was significantly different between AIS patients with a pathological CRT (5°±1.4° for right rotation; 4.2°±0.9° for left rotation) compared with AIS patients with a normal CRT (2.7°±0.6° for right rotation; 2.9°±0.8° for left rotation) or with the control group (3.5°±2.1° for right rotation; 3.1°±1.2° for left rotation). Cervical proprioception is impaired in certain AIS patients. This anomaly may worsen the prognosis of AIS (headache; balance disorders; worsened spinal deformity; complication after spinal fusion). We recommend systematic screening for altered cervical proprioception in AIS patients.