La cifosis relacionada con la edad a menudo se debe a la debilidad de los huesos de la columna vertebral, que hace que se fracturen y. Trouble viewing this page? Go to our diagnostics page to see what’s wrong. como la escoliosis, cifosis o lordosis. cpdo. vertebral llamadas cifosis y lordosis postural vertebral, cifosis dorsal y lumbar lordosis en los adolescentes y el.
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To quantify the changes in cervical sagittal alignment of patients with adolescent idiopathic scoliosis AIS who cirosis surgical treatment. Retrospective study of radiographic data analysis. Data were collected from 25 radiographs of patients with AIS, and 18 cases were included. The mean age was Scoliotic curves were analyzed and measured in anterior posterior views by the Cobb method and classified according to the Lenke classification.
Eighteen adolescent patients were evaluated with a mean follow-up of There was a negative correlation Thus, the correlation becomes positive when compared cifsis postoperative period 0.
We concluded that the correction of adolescent idiopathic scoliosis did not bring about statistically significant changes in the cervical spine, with respect to angle values. Lordotic cervical curves with greater angular value showed a greater variation in the postoperative period, resulting in a better biomechanical balance. Fueron evaluados dieciocho pacientes adolescentes, con un seguimiento promedio de 31,3 meses.
The objectives of the surgical treatment of adolescent idiopathic scoliosis AIS are to prevent the progression of the curve, to correct the three-dimensional deformity, and to restore coronal and sagittal balance.
For many escliosis, only restoration of coronal balance was possible. The advent of new techniques and technological innovations in implants made correction in more than one plane possible and gave rise to a new concept focusing on deformities from a three-dimensional perspective.
Historically, the loss of sagittal balance has played an important role in the pathogenesis of AIS. Dickson confirmed that a loss of thoracic kyphosis can precede the development of deformity and vertebral rotation. Long-term studies have documented consequences such as complaints of low back pain, degenerative disc disease, and difficulty in maintaining upright posture.
The cervical spine is little mentioned in AIS surgical outcomes. In a recent retrospective study, Lee et al. The objective of this study is to quantify the changes in sagittal cervical alignment in patients with AIS who underwent surgical treatment.
This was a retrospective study that evaluated imaging examinations and medical records. A total of 29 patients from March,to October,duly followed-up in a single spine escoliosix, were submitted to inclusion and exclusion criteria and reviewed retrospectively.
Problemas de espalda: cifosis
The inclusion criteria were 1 patients with idiopathic scoliosis submitted to posterior multisegmental instrumentation, 2 the absence of neurological deficits, 3 the absence of previous spine surgery, and 4 the absence of spondylolisthesis. The exclusion criteria were poor radiographical quality for the correct measurement of the vertebral u. All the patients were operated on in the ventral decubitus position. The derotation maneuver was used in all patients. Distraction cifoosis applied to the concavity, with compression on the convex side.
The rods were molded to restore thoracic kyphosis and lumbar lordosis. The demographic data collected were age and sex. The radiographic measurements used were the angles of thoracic kyphosis and lumbar lordosis. The angles were measured using the Cobb method. Thoracic sagittal alignment was measured between the upper edge of T5 and the lower edge of T Finally, lumbar lordosis was measured between the upper plateau of L1 and the upper plateau of S1.
In the anterior-posterior views, the scoliotic curves were measured and classified using the criteria of Lenke et al. Two examiners retrospectively evaluated the pre- and postoperative radiographs.
The radiographs were taken in the prone position, in two views anterior-posterior and lateral using 30×90 cm film. The analysis of the frequency distribution of the categorical variables and the lordodis of the dscoliosis tendency measurements for the continuous variables were conducted to define the profile of the study participants.
The Wilcoxon test was used to compare the pre- and postoperative measurements. Verifications of the type of distribution Gaussian or non-Gaussian and of the homogeneity of the variances were performed using the Shapiro-Wilk and Levene tests, respectively.
An analysis was conducted to escoliisis the association between the selected variables and the variation in cervical lordosis in the postoperative period. Eighteen adolescent patients, all female, between the ages of 13 and 17 years with an average age of The average follow-up was The radiographical evaluations of the angle measurements of cervical lordosis, thoracic kyphosis, and lumbar lordosis of each case are displayed in Table 1 and the average angles are displayed in Table 2.
According to the Lenke classification, 10 of the patients had curve type 1 None of the patients had type 2 or 4 curves. When the pre- and postoperative cervical lordosis and thoracic kyphosis angle measurements were compared, we noted a reduction in the variability of the measurements following surgical intervention, especially in cifosjs to thoracic kyphosis, when we observed the narrowing of the limits in the graphs, demonstrating a lordois relationship between the changes in cfosis thoracic and cervical curves.
From the dispersion of lordoss measurements evaluated compared to each other and to their changes in angulation following surgery, an inversion of the slope of the line for the changes in the measured angles olrdosis cervical lordosis, as compared to their measurements before and after surgery was observed.
THE EFFECT OF CORRECTIVE SURGERY OF SCOLIOSIS ON CERVICAL LORDOTIC AXIS
The same was observed with thoracic kyphosis, for the measurement itself. The inversion of the relationship of change observed following surgery with the pre- and postoperative measurements is verified by the Pearson correlation presented between them. A negative correlation That is, the greater the angle obtained, on average, the greater the reduction. Thus, the correlation becomes positive as compared to the post-surgery measurement 0. The same behavior is observed for thoracic kyphosis, having a negative correlation when comparing its pre-surgical change Moreover, this behavior was not statistically significant in the correlations between cervical lordosis versus the variation in thoracic kyphosis and for measurements of thoracic kyphosis versus the variation in cervical lordosis.
In our study, the effect of surgery on the angular measurements of the sagittal curves of the spine showed that there was no statistically significant correlation between the pre- and postoperative curves.
However, in observing the pre- and postoperative changes in cervical lordosis, we noted that the cervical curves with the greater angular values obtained greater variations following correction of the scoliosis. Thus, it is speculated that the greater the cervical lordosis prior to surgery, the greater its capacity to aid the compensation of the thoracic curves.
Therefore, these patients may have a tendency to acquire more spinal stability with less mechanical force. This can have an impact on the clinical outcomes in terms of mechanical overload on the joints, which remain with mobility intact, but this can only be concluded through the long-term follow-up of these patients. As demonstrated by Kim et al. Previous studies have demonstrated the limitations of the materials for improving hypokyphotic curves, especially in constructions with pedicle screws and hooks.
In our observations, even though the surgery did not significantly modify the cervical curve, there was a higher capacity for adaptation in the most lordotic patients, which could result in a lower incidence of junctional kyphosis due to the probable better distribution of mechanical loads.
Our study did not identify this complication during the average follow-up They concluded that the lumbar lordosis remaining following surgery influenced the cervical lordosis and there was a statistically significant correlation between thoracic kyphosis and cervical lordosis, just as in our study. This correlation was found when they evaluated the proximal portion of the thoracic spine alone – the T1 slope significantly influenced cervical lordosis.
On the other hand, several authors have reported a worsening of the cervical sagittal alignment following correction of the thoracolumbar curves, demonstrating the importance of the relationship between these curves in the postoperative period.
These studies have limitations: Secondly, the variety of curves operated on, that is, the heterogeneity of the curves in the same sample is a limitation. Certainly, selecting only cases submitted to thoracic spine arthrodesis would create a standard for an analysis with fewer variants. Thirdly, large-scale multicenter studies cifosus offer more comprehensive research on the evaluation of the effect of the surgical treatment of icfosis on cervical lordosis.
We concluded that the correction of adolescent idiopathic scoliosis did not bring about statistically significant changes to the cervical spine, in terms of the angular values. The higher-value lordotic curves demonstrate greater postoperative variation, better supporting biomechanical balance, following the correction of the scoliosis.
Difosis etiology and pathogenesis of idiopathic scoliosis. Excessive thoracic lordosis and loss of pulmonary function in patients with idiopathic scoliosis. J Bone Joint Surg Am.
The effect of corrective surgery on pulmonary function in scoliosis. Cervical spine sagittal alignment variations u posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. Cervical degenerative changes in idiopathic scoliosis patients who underwent long fusion to the sacrum as adults: Long-term follow-up of fused and unfused idiopathic scoliosis.
J Bone Joint Surg Br. Long-term follow-up of scoliosis fusion. A retrospective study to reveal the effect of surgical correction of cervical kyphosis on thoraco-lumbo-pelvic sagittal alignment. Proximal junctional kyphosis in adolescent idiopathic scoliosis after 3 different types of posterior segmental spinal instrumentation and fusions: Spine Phila Pa Coronal and sagittal plane correction in adolescent idiopathic scoliosis: A pedicle screw construct gives an enhanced posterior correction of adolescent idiopathic scoliosis when compared with other constructs: Charles YP, et al.
Meaning of “cifosis” in the Spanish dictionary
Cervical sagittal alignment in idiopathic scoliosis treated by posterior instrumentation and in situ bending. Cervical sagittal plane decompensation after surgery for adolescent idiopathic scoliosis: Rodovia BR Norte, Km All the authors declare that there are no potential conflicts of interest regarding this ar.
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April 29, ; Accepted: How to cite this article.