Friday, September 28, 2018 3:00 PM–4:00 PM abstracts: spinal deformity analysis: 221. Cervical deformity in adolescent idiopathic scoliosis patients: Is it clinically significant?

Abstract

BACKGROUND CONTEXT It has been reported that there is a significant correlation between the loss of thoracic kyphosis and the development of cervical kyphosis in Adolescent Idiopathic Scoliosis (AIS) patients. However, the clinical significance of cervical deformityin AIS patients is not clear. PURPOSE To evaluate the relationship between cervical deformity and neck pain in AIS patients. STUDY DESIGN/SETTING Retrospective comparative study. PATIENT SAMPLE A total of 99 consecutive AIS patients. OUTCOME MEASURES C2-C7 sagittal vertical axis (C2–C7SVA), C2-C7 lordosis, neck pain VAS score. METHODS We retrospectively analyzed a consecutive series of AIS patients from a single center. Radiographic measurements included Cobb angle, C2-C7SVA, and C2-C7 lordosis. Cervical deformity was defined as loss of lordotic or neutral cervical angle (CK) or C2-C7SVA more than 4 cm (CPSM). Patients were stratified by the presence of CK and/or CPSM. The Visual Analogue Scale(VAS) was used to assess the patients’ neck pain. The patients’ demographics were also recorded. RESULTS A total of 99 patients were included in this study. The patients’ mean age was 14 years (range 10–18). Mean cervical lordosis and C2-C7SVA were 1.5° and 30.4mm respectively. CK and CPSM prevalence were 49% and 16%, respectively, and the prevalence of CK and/or CPSM was 59%. Twenty six percent of the patients had neck pain and their median pain scores were 2.3 points (range 0.5–8.2 points). There is no correlation between CK and neck pain (26.7% vs. 25.6%, p>.05), between CPSM and neck pain (42.9% vs. 23.0%, p>.05), and between CK and/or CPSM and neck pain (28.8% vs. 22.2%, p>.05). CONCLUSIONS In this series, cervical deformity is present in 59% and neck pain is present in 26% of AIS patients. However, there is no correlation between cervical deformity and neck pain. Our data suggests that the loss of cervical lordosis is a compensatory maneuver in AIS patients and it may not be clinically significant.