Patients with AIS developed cervical malalignment that persisted into adulthood

ORLANDO, Fla. — A 30-year follow-up showed patients treated for adolescent idiopathic scoliosis between 1975 and 1992 underwent various types of cervical spine surgery in adulthood. Although 60% of them had cervical spine arthritis, it was not clear to investigators at the Mayo Clinic, in Rochester, Minn., as to whether these patients truly had cervical spine disease.

“We found there was a high prevalence of cervical kyphosis in our population of 47%, which is normal within the realm of the literature,” Ernest Young, MD, said during a presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.

Young and colleagues conducted their study to examine the outcomes of pediatric patients treated for adolescent idiopathic scoliosis (AIS) during a 20-year period who also had 30 years of follow-up to look for cervical disease. Investigators also sought to identify arthritis as defined by the Kellgren-Lawrence scale or any alterations in thoracic sagittal alignment.

Initial AIS treatment was operative in 21 patients and nonoperative in 12 patients. Patients needed good full-spine radiographs to be included in this study.

Young and colleagues looked at certain markers for cervical disease as defined in the literature and also rated the patients’ alignment based on the parameters of cervical spine alignment, such as the extent of kyphosis or lordosis.

“There was no correlation between the cervical alignment and the eventual patient-reported outcomes for arthritis or surgery,” Young said.

He discussed the cervical alignment results at follow-up: “Most of our patients were kyphotic by definition of 10°, and those rates were about the same between the operative and nonoperative groups,” he said. Furthermore, most of the patients had normal kyphosis in the thoracic spine at follow-up, however.

“The vast majority or 60% of our patients had moderate to severe cervical arthritis at follow-up,” however, there were no differences in arthritis rates between the operative and nonoperative patients, Young said. – by Susan M. Rapp

 

Reference:

Young E, et al. Paper #91. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla.

 

Disclosure: Young reports no relevant financial disclosures.

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