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Updated: Jul 19, 2025

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
The seventh cervical vertebra is an appropriate landmark for thoracic kyphosis measures using distance from the wall
Arpassanan Wiyanad1,2,3, Sugalya Amatachaya1,2,4, Pipatana Amatachaya2,5,6
1School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand.
Background:
Hyperkyphosis is frequently found nowadays due to the change in current lifestyles and age-related system decline. A simple hyperkyphosis measurement can be made easily using the perpendicular distance from the landmark to the wall. However, the existing evidence applied two different landmarks [occiput and the seventh cervical vertebra (C7)] and the measurement using rulers was susceptible to error due to their misalignment.
Objective:
To assess an appropriate landmark for thoracic kyphosis measurement using distance from the wall (KMD), by comparing between occiput and C7, as measured using rulers and verified using data from a specially developed machine, the so-called infrared-gun kyphosis wall distance tool (IG-KypDisT), and the Cobb angles.
Methods:
Community-dwelling individuals with a risk of thoracic hyperkyphosis (age years, ) were cross-sectionally assessed for their thoracic hyperkyphosis using the perpendicular distance from the landmarks, occiput and C7, to the wall using rulers and IG-KypDisT. Then the Cobb angles of these participants were measured within seven days.
Results:
The outcomes from both landmarks differed by approximately 0.8 cm ( 0.084). The outcomes derived from C7 were more reliable (ICCs>0.93, 0.001), with greater concurrent validity with the radiologic data ( 0.738, 0.001), with the overall variance predicted by the regression models for the Cobb angles being higher than that from the occiput (47-48% from C7 and 38-39% from occiput). The outcomes derived from rulers and IG-KypDisT showed no significant differences.
Conclusion:
The present findings support the reliability and validity of KMD assessments at C7 using rulers as a simple standard measure of thoracic hyperkyphosis that can be used in various clinical, community, and research settings.
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