Curve progression in idiopathic scoliosis.

Weinstein, Stuart L.; Ponseti, Ignacio V.

doi:10.2106/00004623-198365040-00004

Cited by 545 publications

(280 citation statements)

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“…A strong relationship between a Cobb angle of C30°and curve progression has already been established in other types of scoliosis. One paper included a 40-year follow-up of AIS patients with a Cobb angle of C30°, and showed curve severity to be an important risk factor for curve progression in skeletally mature patients [28]. Similar results are found for idiopathic juvenile scoliosis [47].…”

Section: Insufficient Evidencementioning

confidence: 76%

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De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

et al. 2016

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Purpose To identify prognostic factors for curve progression in de novo degenerative lumbar scoliosis (DNDLS) by performing a systematic review of the literature. Methods Studies were selected for inclusion following a systematic search in the bibliographic databases PubMed and EMBASE prior to September 2015 and hand searches of the reference lists of retrieved articles. Two authors independently assessed methodological quality. Data were extracted and presented according to a best evidence synthesis. Results The literature search generated a total of 2696 references. After removing duplicates and articles that did not meet inclusion criteria, 12 studies were included. Due to the lack of statistical analyses, pooling of data was not possible. Strong evidence indicates that increasing intervertebral disk degeneration, lateral vertebral translation C6 mm, and an intercrest line through L5 (rather than L4) are associated with DNDLS curve progression. Moderate evidence suggests that apical vertebral rotation Grade II or III is associated with curve progression. For the majority of other prognostic factors, we found limited, conflicting, or inconclusive evidence. Osteoporosis, a coronal Cobb angle \30°, lumbar lordosis, lateral osteophytes difference of C5 mm, and degenerative spondylolisthesis have not been shown to be risk factors. Clinical risk factors for progression were not identified. Conclusions This review shows strong evidence that increased intervertebral disk degeneration, an intercrest line through L5, and apical lateral vertebral translation C6 mm are associated with DNDLS curve progression. Moderate evidence was found for apical vertebral rotation (Grade II/III) as a risk factor for curve progression. These results, however, may not be directly applicable to the individual patient.

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Section: Insufficient Evidencementioning

confidence: 76%

“…In DNDLS, to date, curve progression is unpredictable. Weinstein and Ponseti 1983 showed that 68 % of curves in AIS as well as adult scoliosis progressed more than 5°after skeletal maturity [28]. In addition, they demonstrated that the progression rate in adult scoliosis is much higher in comparison with AIS.…”

Section: Introductionmentioning

confidence: 99%

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

et al. 2016

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“…As treatment in patients with scoliosis is based on the degree of the curve, a precise measurement is crucial for the decisions of the treating physician [7,13]. As modern digital imaging techniques have become widespread in most hospitals, we aimed to evaluate the reproducibility of Cobb angle measurement with digital and manual angle measurement tools.…”

Section: Discussionmentioning

confidence: 99%

Inter- and intraobserver reliability assessment of the Cobb angle: manual versus digital measurement tools

et al. 2007

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The objective of this study is to determine the intraobserver and interobserver reliability of end vertebra definition and Cobb angle measurement using printed and digital radiographs of 48 patients with scoliosis. The Cobb angle and the end vertebra were assessed by six observers in 48 patients with scoliosis using printed and digital radiographs. Definition of end vertebra and measurement of the Cobb angle was repeated three times with a 3 week interval. Intraclass correlation coefficients (ICC) were used to determine the interobserver and intraobserver reliabilities. 95% prediction limits for the errors in measurements are provided. For the Cobb angle a mean ICC of 0.97 was determined for intra-and interobserver reliability measurement of the printed radiographs. For the electronic radiographs a mean ICC value of 0.93 was determined for interobserver reliability and a mean ICC value of 0.96 for intraobserver reliability. Intraobserver ICC for definition of end vertebrae was 0.8 for both methods. Interobserver ICC was 0.83 for the manual and 0.74 in the digital method. One pitfall in angle measurement implies the Cobb method itself which measures in two dimensions. Until we develop a proper tri-dimensional measuring system an error is introduced. For the Cobb angle measurement the definition of end vertebrae introduces the main source of error. Digital radiography does not improve the measurement accuracy.

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“…According to both Bunnell [3] and Lonstein and Carlson [29], nearly 70% of patients with a Risser sign of 0 progressed greater than 5°for curves between 20°and 30°. Weinstein and Ponseti [55] followed curves for an average of 40 years and nearly 70% of curves measuring a minimum of 30°progressed after skeletal maturity. Similarly, Nachemson and Peterson [32] demonstrated 66% of observed patients with idiopathic scoliosis curves measuring 20°to 35°progressed 6°.…”

Section: Natural Historymentioning

confidence: 98%

“…This definition provides a starting point for treatment decisions in the growing spine. Left untreated in the growing child, numerous studies have demonstrated the negative long-term prognosis a progressive curve fosters into adulthood, including back pain, pulmonary compromise, cor pulmonale, psychosocial effects, and even death [8,9,43,[54][55][56]. Curve progression is the most important factor in the natural history of idiopathic scoliosis.…”

Section: Introductionmentioning

confidence: 99%

Brace Management in Adolescent Idiopathic Scoliosis

Schiller

Thakur

Eberson

2010

Clinical Orthopaedics &Amp; Related Research

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Skeletally immature patients with adolescent idiopathic scoliosis are at risk for curve progression. Although numerous nonoperative methods have been attempted, including physical therapy, exercise, massage, manipulation, and electrical stimulation, only bracing is effective in preventing curve progression and the subsequent need for surgery. Brace treatment is initiated as either full-time (TLSO, Boston) or nighttime (Charleston, Providence) wear, although patient compliance with either mode of bracing has been a documented problem. We review the natural history of adolescent idiopathic scoliosis, identify the risks for curve progression, describe the types of braces available for treatment, and review the indications for and efficacy of brace treatment.

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Curve progression in idiopathic scoliosis.

Cited by 545 publications

References 0 publications

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

Inter- and intraobserver reliability assessment of the Cobb angle: manual versus digital measurement tools

Brace Management in Adolescent Idiopathic Scoliosis

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