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Understanding Thoracic Spine Morphology, Shape, and Proportionality.

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Thoracic kyphosis (TK) shape varies in asymptomatic adults. Its distribution changes with magnitude, becoming symmetrical around T7 as TK increases, aiding surgical planning.

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Area of Science:

  • Spinal anatomy and biomechanics
  • Radiographic assessment of spinal curvature

Background:

  • Understanding spinal anatomy requires a 3D perspective.
  • Traditional thoracic kyphosis (TK) definition (T4-T12 angle) lacks detail on adult TK shape.

Purpose of the Study:

  • Describe thoracic kyphosis (TK) in asymptomatic adults.
  • Evaluate the association between TK magnitude and its shape.

Main Methods:

  • Retrospective review of standing radiographs from 119 asymptomatic volunteers.
  • Collected T1-12, T4-12, maximum TK, vertebral tilt, and cumulative TK data.
  • Stratified cohort by T1-12 angle and performed regression analyses.

Main Results:

  • Mean T1-12 kyphosis was 49.5°, T4-12 was 41.5°, and maximum TK was 52.6°.
  • Kyphosis apex was consistently at T6-T7.
  • T1-12 angle predicted upper thoracic kyphosis (T1-7).

Conclusions:

  • Thoracic kyphosis is not a simple arc; its distribution changes with magnitude.
  • Low TK has 2/3 in the upper thoracic region; higher TK becomes symmetrical around T7.
  • Predicting upper thoracic kyphosis from total TK aids in estimating surgical compensation.