Shoulder and Neck Balance in Adolescent Idiopathic Scoliosis: Which Radiographic Indices are Reliable and Practical?
https://doi.org/10.5704/MOJ.2403.007
- Author:
Vo QDN
1
;
Nguyen HHH
2
;
Nguyen HT
1
;
Pham BN
1
;
Truong TK
1
Author Information
1. Department of Pediatric Orthopaedic, Hospital for Traumatology and Orthopedics, Ho Chi Minh City, Vietnam
2. Department of Orthopaedic, Tay Nguyen University, Buon Ma Thuot, Vietnam
- Publication Type:Journal Article
- Keywords:
clavicle rib intersection distance, clavicle chest cage angle difference, T1 tilt angle, difference of outer shoulder height, neck tilt angle
- From:Malaysian Orthopaedic Journal
2024;18(No.1):51-59
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Deformities of the spine and thorax in
adolescent idiopathic scoliosis affect appearance. They are a
cause of inferiority, affecting psychological well-being and
the social life of the patients. To contribute to curve
evaluation, planning in curve correction, and improving the
post-operative aesthetics, many studies on the correlation
between appearance and radiography in the assessment of
shoulder and neck balance have been reported recently. In
general, these studies did not clarify which indices are
required to evaluate shoulder and neck balance. This study
aimed to learn about indices to assess shoulder and neck
balance in adolescent idiopathic scoliosis in correlation
between clinical appearance and radiography.
Materials and methods: This observational study recruited
50 patients with adolescent idiopathic scoliosis who were 12
to 18 years of age with Cobb angle >10°. Based on Pearson
correlation coefficient, radiographic parameters such as
coracoid height difference (CHD), clavicle rib intersection
distance (CRID), clavicle angle (CA), clavicle chest cage
angle difference (CCAD), and T1 tilt angle were evaluated in
correlation with clinical shoulder and neck balance by
difference of inner shoulder height (SHi), difference of outer
shoulder height (SHo), and neck tilt angle.
Results: SHi was moderately correlated with T1 tilt angle (r
[hereafter] = 0.45), CA (0.47), and CHD (0.57), highmoderately correlated with CRID (0.64), very-highly
correlated with CCAD (0.84). SHo was moderately
correlated with T1 tilt angle (0.43), highly correlated with
CHD (0.60), CA (0.63), and CRID (0.72), and very-highly
correlated with CCAD (0.89). T1 tilt angle was highmoderately correlated with neck tilt angle (0.76). The
correlation coefficients between clinical and radiographic
shoulder and neck balance according to sex, BMI, type of
main curve, severity of main curve did not change
significantly.
Conclusion: There was a very high correlation between SHo
(shoulder tilt) and CCAD (0.89); the correlation between
SHo and CRID was high-moderate (0.72), but CRID is easier
than CCAD to evaluate on radiographs. On the other hand,
T1 tilt angle, which is the easiest radiographic parameter to
evaluate, had a high-moderate correlation with neck tilt
angle (0.76) but a moderate correlation with SHo (0.43).
- Full text:202408071246385357516.2024my1351.pdf
