A Retrospective Cross-Sectional Analysis of Abnormal Cervical Mechanics in Patients With Scoliosis

Adolescent Idiopathic Scoliosis (AIS) is a complex spinal deformity that affects millions around the globe. Prevailing theories limit the scope of the spinal deformity to only the scoliotic affected area.  Objective: The aim of this study is to investigate the biomechanical relationship between cervical mechanics and AIS. Research is warranted to evaluate the specific mechanical correlations and potential contributory role of altered dynamic cervical alignment in the development or progression of scoliotic deformities.  Methods: This study was designed as a cross-sectional, descriptive, and retrospective analysis. This study included 37 participants for analysis. Cervical Lateral (Neutral, Flexion, Extension), AP scoliosis radiographs with computer-aided quantitative measurements were recorded for cervical lordosis, cervical segmental instability, and scoliosis Cobb angles. Anterior head translation (AHT) was measured from C2 to C7. Global cervical shape was compared to known buckling patterning. Quantification of the scoliosis utilized the Cobb scoliosis method of measurement.

This study's data strongly support the hypothesis that all AIS patients exhibit a loss of cervical lordosis, with cervical instability contributing to abnormal biomechanics associated with cervical buckling. A high percentage of the participants measured abnormal segmental translation, highest at 70.3% C3-C4 (p=0.0011). A lower proportion of patients (21.6%, p=0.9999) met the threshold for segmental angulation. The majority of patients (33 out of 37; 89.2%) exhibited Order 1 buckling. Four patients (10.8%) demonstrated Order 2 buckling.

This case series demonstrates a correlation between AIS participants, cervical instability, cervical hypolordosis, and cervical buckling. This study adds to the literature by reviewing the abnormal cervical mechanics in AIS patients.