The Relationship Between the Clavicular Tilt Angle and Sagittal Spinal Alignment Associated With Hyperkyphosis...

Area of Science:

• Orthopedics
• Radiology
• Geriatrics

Background:

• Hyperkyphosis, a spinal deformity, is typically assessed using metrics like sagittal vertical axis (SVA), thoracic kyphosis (TK), and lumbar lordosis angle (LLA).
• Evaluating these spinal alignment parameters is challenging in patients unable to maintain a standing or sitting position.
• Current methods for hyperkyphosis assessment are posture-dependent, limiting their applicability in frail or immobile elderly populations.

Purpose of the Study:

• To investigate the potential of the mean clavicular tilt angle as a reliable indicator of hyperkyphosis.
• To determine if the mean clavicular tilt angle correlates with established spinal alignment parameters (SVA, TK, LLA).
• To assess a newly devised method for measuring clavicular tilt angle for improved applicability in diverse patient postures.

Main Methods:

• A retrospective analysis of 106 patients (≥65 years) undergoing lumbar spinal canal stenosis surgery.
• Collection of frontal plane radiographs (including clavicles) and sagittal plane radiographs (entire spine) prior to surgery.
• Measurement of mean clavicular tilt angle using conventional and a novel method, followed by correlation analysis with SVA, TK, and LLA.

Main Results:

• The conventional method showed a positive correlation between mean clavicular tilt angle and thoracic kyphosis (TK).
• The new measurement method demonstrated moderate to strong correlations: positive with sagittal vertical axis (SVA) and negative with lumbar lordosis angle (LLA).
• These findings suggest the mean clavicular tilt angle is associated with key spinal alignment parameters.

Conclusions:

• The mean clavicular tilt angle shows potential as a useful indicator for assessing hyperkyphosis.
• The newly devised measurement method offers a practical tool for evaluating hyperkyphosis, particularly in immobile or frail patient populations.
• Further validation through larger, prospective studies is recommended to confirm these findings.