Kai Sun, Xu Sun, Zezhang Zhu, Yong Qiu, Song Li, Jie Zhou, Yitong Zhu, Yanyu Ma, Saihu Mao
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The differences among different subtypes in deformity parameters and bony structures were compared to identify the causative factors predisposing to different subtypes.</p><p><strong>Results: </strong>98 patients were classified into Type A (47 cases), Type B (31 cases), and Type C (20 cases). The Kappa test showed excellent reliability (Kappa value = 0.847) and reproducibility (Kappa value = 0.881). The proportions of Klippel-Feil syndrome in Types B (71.0%) and C (85.0%) were significantly higher than in Type A (46.8%; all P < 0.05). Type A (66.0%) and Type B (71.0%) predominantly had their hemivertebra (HV) at T3 or T4, while Type C (75%) mostly had HV at T1 or T2. Type B exhibited the most severe trunk tilt, head shift, neck tilt, head tilt, and coronal balance distance (all P < 0.05). Type C had the lowest T1 tilt and first rib angle despite the greatest cervicothoracic Cobb angle (all P < 0.05).</p><p><strong>Conclusions: </strong>This novel reliable classification allows a better understanding of structural diversity and different coronal compensatory mechanisms for the natural progression of CTS-HV. It can contribute to determining the individualized treatment strategy and standardizing academic communication for this rare clinical entity.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4426-4436"},"PeriodicalIF":2.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A novel classification of congenital cervicothoracic scoliosis: identification of coronal subtypes and their prognostic significance.\",\"authors\":\"Kai Sun, Xu Sun, Zezhang Zhu, Yong Qiu, Song Li, Jie Zhou, Yitong Zhu, Yanyu Ma, Saihu Mao\",\"doi\":\"10.1007/s00586-024-08527-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To propose a novel classification system for stratifying coronal curve patterns in congenital cervicothoracic scoliosis with hemivertebrae (CTS-HV).</p><p><strong>Methods: </strong>Type A: regional cervicothoracic deformity only disturbing the balance of head-neck-shoulder complex; Type B: cervicothoracic deformity with significant trunk tilt to the convex side; Type C: cervicothoracic deformity with a significant compensatory thoracic curve. 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引用次数: 0
摘要
目的提出一种新的分类系统,用于对伴有半椎体的先天性颈胸脊柱侧凸(CTS-HV)的冠状曲线模式进行分层:A型:仅影响头颈肩复合体平衡的区域性颈胸椎畸形;B型:躯干明显向凸侧倾斜的颈胸椎畸形;C型:胸廓曲线明显代偿的颈胸椎畸形。可靠性和再现性通过 Kappa 检验进行评估。比较了不同亚型在畸形参数和骨骼结构方面的差异,以确定导致不同亚型的致病因素:98例患者被分为A型(47例)、B型(31例)和C型(20例)。Kappa 检验显示了极佳的可靠性(Kappa 值 = 0.847)和可重复性(Kappa 值 = 0.881)。B 型(71.0%)和 C 型(85.0%)中 Klippel-Feil 综合征的比例明显高于 A 型(46.8%;均为 P 结论:这种新的可靠分类方法有助于更好地了解 CTS-HV 自然进展的结构多样性和不同的冠状动脉代偿机制。它有助于针对这一罕见的临床实体确定个体化治疗策略并规范学术交流。
A novel classification of congenital cervicothoracic scoliosis: identification of coronal subtypes and their prognostic significance.
Objective: To propose a novel classification system for stratifying coronal curve patterns in congenital cervicothoracic scoliosis with hemivertebrae (CTS-HV).
Methods: Type A: regional cervicothoracic deformity only disturbing the balance of head-neck-shoulder complex; Type B: cervicothoracic deformity with significant trunk tilt to the convex side; Type C: cervicothoracic deformity with a significant compensatory thoracic curve. The reliability and reproducibility were assessed via the Kappa test. The differences among different subtypes in deformity parameters and bony structures were compared to identify the causative factors predisposing to different subtypes.
Results: 98 patients were classified into Type A (47 cases), Type B (31 cases), and Type C (20 cases). The Kappa test showed excellent reliability (Kappa value = 0.847) and reproducibility (Kappa value = 0.881). The proportions of Klippel-Feil syndrome in Types B (71.0%) and C (85.0%) were significantly higher than in Type A (46.8%; all P < 0.05). Type A (66.0%) and Type B (71.0%) predominantly had their hemivertebra (HV) at T3 or T4, while Type C (75%) mostly had HV at T1 or T2. Type B exhibited the most severe trunk tilt, head shift, neck tilt, head tilt, and coronal balance distance (all P < 0.05). Type C had the lowest T1 tilt and first rib angle despite the greatest cervicothoracic Cobb angle (all P < 0.05).
Conclusions: This novel reliable classification allows a better understanding of structural diversity and different coronal compensatory mechanisms for the natural progression of CTS-HV. It can contribute to determining the individualized treatment strategy and standardizing academic communication for this rare clinical entity.
期刊介绍:
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe