European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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The line of sight when whole-spine radiographs are taken has not been defined. In our 2012 health screening study (TOEI study), whole-spine radiographs were taken with the volunteers in the most relaxed position and with a horizontal gaze. However, in the TOEI 2014 study, a mirror was placed in front of their faces to unify their line of sight. To our knowledge, there are no reports on how the sagittal alignment changes when radiographs are taken using a mirror. The purpose of this study was to investigate how mirror placement impacted sagittal spinal alignment in whole-spine radiographs taken while standing. ⋯ The smaller McGS variation in the TOEI 2014 study suggested that mirror placement could standardize the head's position. These results showed that the mirror placement retroflexed cervical alignment and caused the head to lean backward. It is important that a mirror is placed to unify the line of sight.
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For patients with adolescent idiopathic scoliosis, shoulder balance influences their treatment satisfaction and psychological well-being. Several parameters are known to affect postoperative shoulder balance, but few prognostic models are as yet available. ⋯ Preoperative variables have the strongest influence on shoulder level after spinal instrumentation. Additionally, extensive correction of the distal thoracic curve can cause elevation of the left shoulder.