Double thoracic adolescent idiopathic scoliosis: clinical evaluation of shoulder balance.

Abstract

Objective To develop several cosmetic parameters for the evaluation of cosmetic shoul-der balance and to investigate the correlation between radiographic and cosmetic shoulder balance in adoles-cent idiopathic scoliosis (AIS) patients with Lenke 2 curve. Methods Thirty-four AIS patients with Lenke 2 curve were recruited for this study. Six cosmetic parameters-inner shoulder height (SHi), outer shoulder height (SHo), shoulder area index 1 (SAI1), shoulder area index 2 (SAI2), shoulder angle (α1) and axilla an-gle (α2) were developed and measured on the standing photographs. Also, seven radiographic parameters-T1 tilting (T1), first rib angle (FRA), clavicle angle (CA), coracoid process height (CPH), clavicle-rib cage inter-section (CRCI), first rib-clavicle height (FRCH), trapezius length (TL) were measured on the standing posteri-or-anterior radiographs. Correlation analysis was made between cosmetic parameters and radiographic pa-rameters. Results The correlation coefficients between SHi and radiographic parameters ranged from -0.12 to 0.61, and SHi was found to be significantly correlated with T1, FRA, CA, CPH and CRCI, among which FRA had the highest correlation coefficient. The correlation coefficients between SHo and radiographic pa-rameters ranged from -0.22 to 0.74, and Silo was significantly correlated with T1, FRA, CA, CPH, CRCI and FRCH, among which CRCI had the highest correlation coefficient. There were also several radiographic parameters correlated significantly with SAI1, SAI2, α1 and α2. Although significant correlation were found between radiographic parameters and cosmetic measurements, none of the correlation coefficient was greater than 0.8. Conclusion Radiographic parameters could partially reflect the shoulder cosmetic appearances. However, none of the existing parameters can accurately reflect the shoulder cosmetic appearance. Hence, we suggest that some of the cosmetic parameters should serve as a supplement to the radiographic parame-ters in the evaluation of shoulder balance clinically. Key words: Scoliosis; Thoracic vertebrae; Shoulder; Radiography; Esthetics