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Purpose <p>The purpose was to describe cervical sagittal alignment in adolescent idiopathic scoliosis (AIS) compared to a normal group of adolescents and young adults, seeking for differences by Lenke type.</p> Methods <p>Radiographs of 1779 AIS patients and 1115 controls were analyzed. Lenke types were determined. Spinopelvic parameters, thoracic kyphosis (TK), lumbar lordosis and sagittal vertical axis (SVA) CAM, C2, and C7 were measured. Cervical parameters included McGregor slope, C1–C2 and McGregor–C2 lordosis, C2–C7 lordosis (subdivided into cranial and caudal arches), C7 and T1 slopes. Cervical alignment patterns were classified as lordotic, kyphotic or sigmoid shapes.</p> Results <p>Lenke 1, 2, 3 and 6 curves showed decreased C2–C7 and caudal arch lordosis associated with decreased C7 and T1 slopes and TK (p &lt; 0.001) compared to normal. Cranial cervical parameters were comparable to the normal group. Lenke 5 patients demonstrated TK, C7 and T1 slopes, and cervical alignment parameters close to the normal group. In AIS, TK correlated with caudal cervical (r = 0.76) and C2-C7 lordosis (r = 0.52), but only weakly with cranial cervical parameters.</p> Conclusion <p>Cervical sagittal alignment compensatory changes in AIS predominantly involve the caudal cervical segment and are closely related to TK, while cranial alignment remains close to normal, supporting horizontal gaze. As opposed to other AIS types with thoracic deformity, Lenke 5 patients had no cervical compensation, and sagittal alignment was close to normal. Distinguishing normative from pathologic compensation across AIS curve types may help optimize surgical planning and restoration of TK to indirectly improve cervical alignment.</p>

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Comparison of cervical sagittal alignment in normal subjects and adolescents and young adults with idiopathic scoliosis

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Lucas Chomienne,
  • Guillaume Battesti,
  • Thibaut Goetsch,
  • Mikael Finoco,
  • Emmanuelle Ferrero,
  • Marc Khalifé,
  • Thierry Odent,
  • Edouard De Charnace,
  • Sebastien Pesenti,
  • Solène Prost,
  • Benjamin Blondel,
  • Federico Solla,
  • Mourad Ould-Slimane,
  • Brice Ilharreborde,
  • Yann Philippe Charles

摘要

Purpose

The purpose was to describe cervical sagittal alignment in adolescent idiopathic scoliosis (AIS) compared to a normal group of adolescents and young adults, seeking for differences by Lenke type.

Methods

Radiographs of 1779 AIS patients and 1115 controls were analyzed. Lenke types were determined. Spinopelvic parameters, thoracic kyphosis (TK), lumbar lordosis and sagittal vertical axis (SVA) CAM, C2, and C7 were measured. Cervical parameters included McGregor slope, C1–C2 and McGregor–C2 lordosis, C2–C7 lordosis (subdivided into cranial and caudal arches), C7 and T1 slopes. Cervical alignment patterns were classified as lordotic, kyphotic or sigmoid shapes.

Results

Lenke 1, 2, 3 and 6 curves showed decreased C2–C7 and caudal arch lordosis associated with decreased C7 and T1 slopes and TK (p < 0.001) compared to normal. Cranial cervical parameters were comparable to the normal group. Lenke 5 patients demonstrated TK, C7 and T1 slopes, and cervical alignment parameters close to the normal group. In AIS, TK correlated with caudal cervical (r = 0.76) and C2-C7 lordosis (r = 0.52), but only weakly with cranial cervical parameters.

Conclusion

Cervical sagittal alignment compensatory changes in AIS predominantly involve the caudal cervical segment and are closely related to TK, while cranial alignment remains close to normal, supporting horizontal gaze. As opposed to other AIS types with thoracic deformity, Lenke 5 patients had no cervical compensation, and sagittal alignment was close to normal. Distinguishing normative from pathologic compensation across AIS curve types may help optimize surgical planning and restoration of TK to indirectly improve cervical alignment.