THE IMPORTANCE OF CLAVICLE ANGLE AND HEIGHT OF THE CORACOID PROCESS IN IDIOPATHIC SCOLIOSIS

ABSTRACT Objective The aim of this study was to correlate the parameters of shoulder alignment with the Cobb angle value of the proximal thoracic curve in the pre and postoperative periods. Methods A retrospective data collection study was carried out, in which 30 medical records and radiographic examinations of patients submitted to surgical treatment for correction of deformity in AIS were performed in a single center from 2010 to 2017. Results The risk of CHD> 3 mm at 1 year postoperatively was similar between patients who had high thoracic curve (HTC) less than or equal to 25 degrees and those who had HTC greater than 25 degrees and not structured (relative risk = 1.75, P-value = 0.552). The risk of presenting CA> 2 degrees in the postoperative period of 1 year was similar between patients having HTC less than or equal to 25 degrees and those who had HTC greater than 25 degrees and not structured (relative risk = 1.31, P-value = 0.567). Conclusions We observed that when the proximal thoracic curve is not structured, even with a high Cobb angle, there is no need for instrumentation, presenting a satisfactory shoulder alignment in the postoperative period . Level of Evidence III; Retrospective and Comparative.

摘要 目的：本研究旨在探讨术前与术后肩对位参数与胸近端弯科布角（Cobb angle）值的相关性。
方法：本研究为回顾性数据收集研究，于2010年至2017年间在单中心纳入30例接受手术矫正青少年特发性脊柱侧凸（Adolescent Idiopathic Scoliosis, AIS）畸形的患者，收集其完整病历资料与影像学检查结果。
结果：术后1年时，高位胸弯（High Thoracic Curve, HTC）≤25°的患者与HTC＞25°且为非结构性的患者，其CHD＞3mm的发生风险无统计学差异（相对风险=1.75，P值=0.552）。术后1年时，HTC≤25°的患者与HTC＞25°且为非结构性的患者，其CA＞2°的发生风险同样无统计学差异（相对风险=1.31，P值=0.567）。
结论：本研究观察到，当胸近端弯为非结构性时，即便科布角数值较大，亦无需实施内固定手术，术后肩对位可获得满意效果。
证据分级：Ⅲ级；回顾性对照研究。