General characteristics in different genders.

<p>General characteristics in different genders.</p

Correlation between T1 sagittal angle and other variables.

<p>Correlation between T1 sagittal angle and other variables.</p

The Relationship between T1 Sagittal Angle and Sagittal Balance: A Retrospective Study of 119 Healthy Volunteers

<div><p>T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal angle could be used for osteotomy guidelines to restore sagittal balance. Medical records of healthy volunteers in our outpatient clinic from January 2014 to August 2015 were reviewed, and their standing full-spine lateral radiographs were evaluated. Demographic and radiological parameters were collected and analyzed, including age, gender, T1 sagittal angle, maxTK, maxLL, SS, PT, and PI. Correlation coefficients between T1 sagittal angle and other spinopelvic parameters were determined. In addition, multiple regression analysis was performed to establish predictive radiographic parameters for T1 sagittal angle as the primary contributors. A total of 119 healthy volunteers were recruited in our study with a mean age of 34.7 years. It was found that T1 sagittal angle was correlated with maxTK with very good significance (r = 0.697, <i>P</i><0.001), maxLL with weak significance (r = 0.206, <i>P</i> = 0.024), SS with weak significance (r = 0.237, <i>P</i> = 0.009), PI with very weak significance (r = 0.189, <i>P</i> = 0.039), SVA with moderate significance (r = 0.445, <i>P</i><0.001), TPA with weak significance (r = 0.207, <i>P</i> = 0.023), and T1SPI with weak significance (r = 0.309, <i>P</i> = 0.001). The result of multiple regression analysis showed that T1 sagittal angle could be predicted by using the following regression equation: T1 sagittal angle = 0.6 * maxTK—0.2 * maxLL + 8. In the healthy population, T1 sagittal angle could be considered as a useful parameter for sagittal balance; however, it could not be thoroughly replaced for SVA. maxTK was the primary contributor to T1 sagittal angle. According to this equation, we could restore sagittal balance by surgically changing thoracic kyphosis and lumbar lordosis, which could serve as a guideline for osteotomy.</p></div

Correlation between T1 sagittal angle and maxTK for the healthy volunteers.

<p>Correlation between T1 sagittal angle and maxTK for the healthy volunteers.</p

Could CCI or FBCI Fully Eliminate the Impact of Curve Flexibility When Evaluating the Surgery Outcome for Thoracic Curve Idiopathic Scoliosis Patient? A Retrospective Study

<div><p>Purpose</p><p>To clarify if CCI or FBCI could fully eliminate the influence of curve flexibility on the coronal correction rate.</p><p>Methods</p><p>We reviewed medical record of all thoracic curve AIS cases undergoing posterior spinal fusion with all pedicle screw systems from June 2011 to July 2013. Radiographical data was collected and calculated. Student t test, Pearson correlation analysis and linear regression analysis were used to analyze the data.</p><p>Results</p><p>60 were included in this study. The mean age was 14.7y (10-18y) with 10 males (17%) and 50 females (83%). The average Risser sign was 2.7. The mean thoracic Cobb angle before operation was 51.9°. The mean bending Cobb angle was 27.6° and the mean fulcrum bending Cobb angle was 17.4°. The mean Cobb angle at 2 week after surgery was 16.3°. The Pearson correlation coefficient r between CCI and BFR was -0.856(P<0.001), and between FBCI and FFR was -0.728 (P<0.001). A modified FBCI (M-FBCI) = (CR-0.513)/BFR or a modified CCI (M-CCI) = (CR-0.279)/FFR was generated by curve estimation has no significant correlation with FFR (r=-0.08, p=0.950) or with BFR (r=0.123, p=0.349).</p><p>Conclusions</p><p>Fulcrum-bending radiographs may better predict the outcome of AIS coronal correction than bending radiographs in thoracic curveAIS patients. Neither CCI nor FBCI can fully eliminate the impact of curve flexibility on the outcome of correction. A modified CCI or FBCI can better evaluating the corrective effects of different surgical techniques or instruments.</p></div

Demographic Characteristics and Clinical Features of the Subjects.

<p>* Paired-samples T test between preoperative lateral bending Cobb and postoperative thoracic Cobb (1 week)</p><p>**Paired-samples T test between preoperative fulcrum bending Cobb and postoperative thoracic Cobb (1 week)</p><p>Demographic Characteristics and Clinical Features of the Subjects.</p

Show that FFR(r = 0.811) has a higher predict value than BFR(r = 0.523) in predicting CR.

<p>(A) scatter plot with correction rate (CR) against bending flexibility rate(BFR) and the linear regression equation of estimating CR by BFR. (B) scatter plot with correction rate (CR) against fulcrum flexibility rate (FFR) and the linear regression equation of estimating CR by FFR.</p

Correlation analysis between BFR (bending flexibility rate), FFR (fulcrum flexibility rate), CCI(correction index), fulcrum bending correction index (FBCI) modified FBCI (M-FBCI), modified CCI (M-CCI).

<p>A: CCI showed significant negative correlation with BFR(r = -0.856, P<0.01). B: FBCI showed significant negative correlation with FFR(r = -0.728, P<0.01). Figs 2A,2B show that both CCI and FBCI could not fully eliminate the influence of BFR and FFR. Means that the preoperative curve flexibility will still affect when using CCI or FBCI to compare the curve corrective ability of different apparatus. C: M- CCI showed no significant correlation with BFR(r = 0.123, P = 0.349). D: M-FBCI showed no significant correlation with FFR(r = -0.008, P = 0.950). Figs 2C,2D show that M-CCI and M-FBCI do not have significant correlation with preoperative curve flexibility. Means that the influence of curve flexibility could be eliminated when use these to compare the curve corrective ability of different apparatus.</p

Results of Pearson Correlation Analysis.

<p>Results of Pearson Correlation Analysis.</p

Clinical Improvements in Lower Back and Leg Pain Syndrome of Adult Idiopathic Scoliotic Patients.

<p>SD indicates standard deviation; ODI, Oswestry disability index; VAS, visual analogue scale.</p