Understanding Thoracic Spine Morphology, Shape, and Proportionality
Retrospective review. The aim of this study was to describe thoracic kyphosis (TK) in a normal asymptomatic population and to evaluate the association between TK magnitude and its shape. Understanding spinal anatomy requires a three-dimensional appreciation of the spine's shape, morphology, and...
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| Vydáno v: | Spine (Philadelphia, Pa. 1976) Ročník 45; číslo 3; s. 149 |
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01.02.2020
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| ISSN: | 1528-1159, 1528-1159 |
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| Abstract | Retrospective review.
The aim of this study was to describe thoracic kyphosis (TK) in a normal asymptomatic population and to evaluate the association between TK magnitude and its shape.
Understanding spinal anatomy requires a three-dimensional appreciation of the spine's shape, morphology, and proportions. The customary definition of TK is the angle between T4 and T12. However, little is known on the actual shape of TK in adults.
Asymptomatic volunteers were recruited; demographic data along with full-body standing radiographs were recorded. Radiographic data such as T1-12 and T4-12 angles were collected. Maximum TK and vertebral orientation/tilt were also collected, in addition to cumulative TK and Centered Kyphosis at T7. The cohort was stratified by T1-12 value (<40°, 40°-60°, and>60°) and comparisons and regressions were performed afterward.
One hundred nineteen subjects were included (average age 50.8 yrs, 81 female). Mean T1-12 kyphosis was 49.5°, mean T4-12 kyphosis 41.5°, and mean maximum TK was 52.6°. T1 was the most anteriorly tilted vertebra, L1 the most posteriorly tilted; T7 was horizontal, independently of T1-12 value or age. Cumulative kyphosis analysis revealed that the apex of kyphosis was located at T6-T7. Regression analysis predicting the value and the percentage of T1-7 both yielded T1-12 as a predictor (Adj. r = 0.32, Adj. r = 0.13).
Changes in kyphosis distribution in an asymptomatic population suggest that TK is not a simple circle arc: with low TK, 2/3 of the kyphosis is located in the upper part and when TK increases, the distribution of kyphosis will be symmetric around T7. It is possible to predict the amount of kyphosis in the upper part using total kyphosis value. This could help estimate preoperative compensation and predict reciprocal change.
3. |
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| AbstractList | Retrospective review.
The aim of this study was to describe thoracic kyphosis (TK) in a normal asymptomatic population and to evaluate the association between TK magnitude and its shape.
Understanding spinal anatomy requires a three-dimensional appreciation of the spine's shape, morphology, and proportions. The customary definition of TK is the angle between T4 and T12. However, little is known on the actual shape of TK in adults.
Asymptomatic volunteers were recruited; demographic data along with full-body standing radiographs were recorded. Radiographic data such as T1-12 and T4-12 angles were collected. Maximum TK and vertebral orientation/tilt were also collected, in addition to cumulative TK and Centered Kyphosis at T7. The cohort was stratified by T1-12 value (<40°, 40°-60°, and>60°) and comparisons and regressions were performed afterward.
One hundred nineteen subjects were included (average age 50.8 yrs, 81 female). Mean T1-12 kyphosis was 49.5°, mean T4-12 kyphosis 41.5°, and mean maximum TK was 52.6°. T1 was the most anteriorly tilted vertebra, L1 the most posteriorly tilted; T7 was horizontal, independently of T1-12 value or age. Cumulative kyphosis analysis revealed that the apex of kyphosis was located at T6-T7. Regression analysis predicting the value and the percentage of T1-7 both yielded T1-12 as a predictor (Adj. r = 0.32, Adj. r = 0.13).
Changes in kyphosis distribution in an asymptomatic population suggest that TK is not a simple circle arc: with low TK, 2/3 of the kyphosis is located in the upper part and when TK increases, the distribution of kyphosis will be symmetric around T7. It is possible to predict the amount of kyphosis in the upper part using total kyphosis value. This could help estimate preoperative compensation and predict reciprocal change.
3. Retrospective review.STUDY DESIGNRetrospective review.The aim of this study was to describe thoracic kyphosis (TK) in a normal asymptomatic population and to evaluate the association between TK magnitude and its shape.OBJECTIVEThe aim of this study was to describe thoracic kyphosis (TK) in a normal asymptomatic population and to evaluate the association between TK magnitude and its shape.Understanding spinal anatomy requires a three-dimensional appreciation of the spine's shape, morphology, and proportions. The customary definition of TK is the angle between T4 and T12. However, little is known on the actual shape of TK in adults.SUMMARY OF BACKGROUND DATAUnderstanding spinal anatomy requires a three-dimensional appreciation of the spine's shape, morphology, and proportions. The customary definition of TK is the angle between T4 and T12. However, little is known on the actual shape of TK in adults.Asymptomatic volunteers were recruited; demographic data along with full-body standing radiographs were recorded. Radiographic data such as T1-12 and T4-12 angles were collected. Maximum TK and vertebral orientation/tilt were also collected, in addition to cumulative TK and Centered Kyphosis at T7. The cohort was stratified by T1-12 value (<40°, 40°-60°, and>60°) and comparisons and regressions were performed afterward.METHODSAsymptomatic volunteers were recruited; demographic data along with full-body standing radiographs were recorded. Radiographic data such as T1-12 and T4-12 angles were collected. Maximum TK and vertebral orientation/tilt were also collected, in addition to cumulative TK and Centered Kyphosis at T7. The cohort was stratified by T1-12 value (<40°, 40°-60°, and>60°) and comparisons and regressions were performed afterward.One hundred nineteen subjects were included (average age 50.8 yrs, 81 female). Mean T1-12 kyphosis was 49.5°, mean T4-12 kyphosis 41.5°, and mean maximum TK was 52.6°. T1 was the most anteriorly tilted vertebra, L1 the most posteriorly tilted; T7 was horizontal, independently of T1-12 value or age. Cumulative kyphosis analysis revealed that the apex of kyphosis was located at T6-T7. Regression analysis predicting the value and the percentage of T1-7 both yielded T1-12 as a predictor (Adj. r = 0.32, Adj. r = 0.13).RESULTSOne hundred nineteen subjects were included (average age 50.8 yrs, 81 female). Mean T1-12 kyphosis was 49.5°, mean T4-12 kyphosis 41.5°, and mean maximum TK was 52.6°. T1 was the most anteriorly tilted vertebra, L1 the most posteriorly tilted; T7 was horizontal, independently of T1-12 value or age. Cumulative kyphosis analysis revealed that the apex of kyphosis was located at T6-T7. Regression analysis predicting the value and the percentage of T1-7 both yielded T1-12 as a predictor (Adj. r = 0.32, Adj. r = 0.13).Changes in kyphosis distribution in an asymptomatic population suggest that TK is not a simple circle arc: with low TK, 2/3 of the kyphosis is located in the upper part and when TK increases, the distribution of kyphosis will be symmetric around T7. It is possible to predict the amount of kyphosis in the upper part using total kyphosis value. This could help estimate preoperative compensation and predict reciprocal change.CONCLUSIONChanges in kyphosis distribution in an asymptomatic population suggest that TK is not a simple circle arc: with low TK, 2/3 of the kyphosis is located in the upper part and when TK increases, the distribution of kyphosis will be symmetric around T7. It is possible to predict the amount of kyphosis in the upper part using total kyphosis value. This could help estimate preoperative compensation and predict reciprocal change.3.LEVEL OF EVIDENCE3. |
| Author | Pesenti, Sebastien Lafage, Renaud Schwab, Frank J Assi, Ayman Lafage, Virginie Steinberger, Jeremy Kim, Han Jo Elysee, Jonathan C Lenke, Lawrence G Iyer, Sravisht |
| Author_xml | – sequence: 1 givenname: Renaud surname: Lafage fullname: Lafage, Renaud organization: Spine Research Laboratory, Hospital for Special Surgery, New York, NY – sequence: 2 givenname: Jeremy surname: Steinberger fullname: Steinberger, Jeremy organization: Spine Research Laboratory, Hospital for Special Surgery, New York, NY – sequence: 3 givenname: Sebastien surname: Pesenti fullname: Pesenti, Sebastien organization: Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France – sequence: 4 givenname: Ayman surname: Assi fullname: Assi, Ayman organization: Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon – sequence: 5 givenname: Jonathan C surname: Elysee fullname: Elysee, Jonathan C organization: Spine Research Laboratory, Hospital for Special Surgery, New York, NY – sequence: 6 givenname: Sravisht surname: Iyer fullname: Iyer, Sravisht organization: Spine Research Laboratory, Hospital for Special Surgery, New York, NY – sequence: 7 givenname: Lawrence G surname: Lenke fullname: Lenke, Lawrence G organization: Columbia University Medical Center, The Spine Hospital, New York-Presbyterian Healthcare System, New York, NY – sequence: 8 givenname: Frank J surname: Schwab fullname: Schwab, Frank J organization: Spine Research Laboratory, Hospital for Special Surgery, New York, NY – sequence: 9 givenname: Han Jo surname: Kim fullname: Kim, Han Jo organization: Spine Research Laboratory, Hospital for Special Surgery, New York, NY – sequence: 10 givenname: Virginie surname: Lafage fullname: Lafage, Virginie organization: Spine Research Laboratory, Hospital for Special Surgery, New York, NY |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31513104$$D View this record in MEDLINE/PubMed |
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| Snippet | Retrospective review.
The aim of this study was to describe thoracic kyphosis (TK) in a normal asymptomatic population and to evaluate the association between... Retrospective review.STUDY DESIGNRetrospective review.The aim of this study was to describe thoracic kyphosis (TK) in a normal asymptomatic population and to... |
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| SubjectTerms | Female Humans Male Middle Aged Radiography, Thoracic Retrospective Studies Thoracic Vertebrae - anatomy & histology Thoracic Vertebrae - diagnostic imaging Thoracic Vertebrae - physiology |
| Title | Understanding Thoracic Spine Morphology, Shape, and Proportionality |
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