ArticleSurgical and radiologic anatomy : SRA2026
Association between thoracic kyphosis and sternoclavicular and scapulothoracic alignment: a cross-sectional opportunistic thoracic CT study.
Article in Surgical and radiologic anatomy : SRA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the cross-sectional association between thoracic kyphosis and static shoulder-girdle alignment on opportunistic thoracic computed tomography (CT), with particular emphasis on scapular orientation and anterior sternoclavicular (SC) joint positioning.
methodsThis single-centre retrospective study included 215 adults undergoing thoracic CT between January 2025 and February 2026. Upper (T1-T5), lower (T5-T12), and measured total (T1-T12) thoracic kyphosis were assessed alongside scapular, clavicular, and SC joint parameters. Associations were examined using Spearman correlation, multivariable linear regression, and parsimonious logistic regression. Inter-rater reliability was assessed in 30 examinations.
resultsMean age was 52.5 ± 15.8 years, and 27 patients (12.6%) demonstrated anterior SC positioning. Greater total T1-T12 kyphosis correlated with smaller bilateral mean scapular plane angle (r = - 0.291, p < 0.001). In multivariable analysis, both T1-T5 (β = -0.267, p < 0.001) and T5-T12 kyphosis (β = -0.130, p = 0.024) were independently associated with smaller scapular plane angles. T1-T5 kyphosis was independently associated with anterior SC positioning (OR 1.080 per degree, 95% CI 1.021-1.141; p = 0.007), while total T1-T12 kyphosis was also associated (OR 1.043, 95% CI 1.002-1.086; p = 0.040). Inter-rater reliability was excellent (ICC 0.962-0.999).
conclusionGreater thoracic kyphosis on supine thoracic CT was associated with altered static shoulder-girdle alignment, particularly greater scapular protraction and anterior SC positioning. Upper thoracic curvature showed the most consistent association with anterior SC position. These findings highlight the potential value of thoracic CT for characterizing clinically relevant shoulder-girdle alignment patterns and provide a foundation for future prospective and functional studies.
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