Degree Of Thoracic Kyphosis Research Articles

Thoracolumbar osteotomy for postsurgical sagittal imbalance.

A prospective study of 12 patients with sagittal plane imbalance after multiple surgeries for scoliosis is reported. Reconstruction was attempted by posterior thoracolumbar junction osteotomy. Eighty-seven degrees of thoracic kyphosis (ending at L3) was improved to forty-one degrees (ending at T12). Lumbar lordosis was increased from 21 to 30 degrees, beginning at L1 afterward (L3 before). 8.7 cm posterior displacement of the sagittal weight-bearing axis was achieved. No permanent complications ensued. The procedure, without anterior surgery, corrects the deformity at the apical area. Cotrel-Dubousset instrumentation secured correction and fixation.

The sagittal configuration and mobility of the spine in idiopathic scoliosis.

The aim of this study is to see how the spinal sagittal configuration and mobility in 127 patients with idiopathic scoliosis are influenced by increasing scoliotic deformity and to determine when this deformity gets clinically significant compared to controls (n = 92). In patients with thoracic curves the degrees of thoracic kyphosis and lumbar lordosis were significantly less than those of the controls. Neither the kyphosis nor the lordosis were correlated to the Cobb angles. Even patients with small curves have straight spines in the sagittal plane; there is no tendency for the kyphosis and lordosis to decrease when the scoliotic deformity increases. This indicates that it is especially individuals with straight spines in the sagittal plane who are prone to develop scoliosis. It is also suggested that the limitation in spinal function for curves with Cobb angles below 50 degrees may be neglected.

Spinal compression fractures in osteoporotic women: patterns and relationship to hyperkyphosis.

A prospective study of thoracic and lumbar spinal fracture distribution and its relationship to thoracic kyphosis was performed in 87 women with osteoporosis. Anterior wedge fractures were most commonly seen in the midthoracic spine and about the thoracolumbar junction, whereas central compression fractures were most common from the first to the fourth lumbar levels. Solitary wedge fractures did not occur above the seventh thoracic vertebra, suggesting that a cause other than osteoporosis must be suspected in any patient with an isolated high thoracic fracture. Analysis of the spinal radiographs obtained in an additional 16 women without osteoporosis revealed that both forms of fracture were unusual in this small group with normal spinal mineralization. The number of anterior wedge fractures in the thoracic spine correlated (r = .546) with the degree of thoracic kyphosis. However, 19% of the women with no thoracic fractures still had thoracic hyperkyphosis. The authors conclude that the hyperkyphosis of osteoporotic women is related to anterior compression fractures but also has contributing nonskeletal factors.

The Interrelation of Spinal Curves, Pelvic Tilt and Muscle Lengths in the Adolescent Female

Thoracic kyphosis, lumbar lordosis and pelvic tilt were measured in standing in one hundred and three adolescent females, using a specially designed inclinometer. Indices of the muscle lengths (abdominals, erector spinae, iliopsoas, gluteals, rectus femoris and hamstrings) were measured using inclinometry and goniometry and expressed as angles of joint position. Multiple regression analysis revealed that the index of erector spinae length was negatively correlated with lumbar lordosis (r = - 0.24, p < 0.05). The abdominal length index was positively correlated with lumbar lordosis (r = 0.209, p < 0.05), and the hamstring length index was negatively correlated with lordosis (r = - 0.213, p < 0.05). No muscle length index was significantly related to pelvic tilt. A negative association between the degree of thoracic kyphosis and the abdominal length index was found (r = -0.245, p < 0.05).

Three-dimensional analysis of right thoracic idiopathic scoliosis.

Three-dimensional spinal analysis was performed on thirty-one female patients with untreated right thoracic idiopathic scoliosis to determine the relationship between the degree of scoliosis and the degree of kyphosis, maximal curvature, and apical vertebral displacement. The degree of scoliosis did not correlate with the degree of thoracic kyphosis. Six patients had thoracic kyphosis over 50 degrees, 19 patients had a kyphosis between 20-50 degrees, and the last six patients had a thoracic kyphosis less than 20 degrees. The apex of the scoliosis was at or below the apex of the thoracic kyphosis in all patients except one. The degree of displacement of the apical vertebrae had a positive correlation (r = 0.732) with the degree of scoliosis. The maximal curvature of the spine was correlated (r = 0.613) with the degree of scoliosis.

特発性側わん症における矢状面カーブの検討

It is well-known that the scoliotic spine has three deformities on each of its three orthogonal planes. A scoliosis with abnormality on the sagittal plane is called lordoscoliosis or kyphoscoliosis. But it is not well-known whether scoliosis is more often complicated with lordosis or kyphosis. We studied one hundred and two scoliotic spines with mild curvature of less than fifty degrees, and seventeen normal spines as controls. The scoliotic spines with thoracic curvature had less degree of thoracic kyphosis and more degree of lumbar lordosis than normal spines. We also estimated the sagittal curvature limited in the three apical vertebrae of the scoliotic spines. In the cases of thoracic curvatures these values were significantly correlated with the degree of curvature on the coronal plane.