Curve Progression in Idiopathic Scoliosis.

Takashita, Mitsuhiro; Oga, Masayoshi; Noguchi, Yasuo; Mashima, Tatsuoki; Taen, Ryoichi; Sugioka, Yôichi

doi:10.5035/nishiseisai.42.146

Cited by 2 publications

(3 citation statements)

References 5 publications

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Section: Introductionmentioning

confidence: 99%

“…Many studies have examined curve progression risk factors in early teenage patients with adolescent idiopathic scoliosis (AIS) [1][2][3][4][5][6][7][8][9][10][11]. Cobb angle at initial presentation and level of skeletal maturation as defined by Risser stage, or more importantly by peak growth velocity, seem to be most strongly correlated with progression [4,5,8,11]. Studies evaluating curve progression in patients with smaller curves during the growth phase are helpful in predicting which will demonstrate progression to a commonly accepted surgical range (40°-50°), but provide no information on longer-term curve progression once the curve has reached the surgical range magnitude.…”

Section: Introductionmentioning

confidence: 99%

“…There is a dearth of published information on the natural history of progression for AIS once a curve has reached the typical surgical recommendation range of 40°-50° [1,11,12]. Current understanding of curve progression past 40° and into adulthood is heavily based on important work originating from one North American center and few others [1,11,12]. It cannot be assumed that curve progression in a typical surgical range patient will be linear at a constant yearly rate if surgery were not to be performed.…”

Section: Introductionmentioning

confidence: 99%

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Intermediate-term annualized curve progression of adolescent idiopathic scoliosis curves measuring 40° or greater

et al. 2020

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Study design Prospective cohort study.Objectives The objective of this study was to examine intermediate-term progression for a large series of patients with adolescent idiopathic scoliosis (AIS) with curves 40° or greater. Background Curve progression in AIS has been well documented for smaller curves in adolescence up to skeletal maturity; however, the data on curve progression past 40° or into adulthood are limited. With many surgeons recommending surgical correction when patients reach this threshold, it is important to understand the radiographic progression of curves into adulthood. Methods A database of all patients seen by a single surgeon from 1984 through 2018 with AIS curves progressing to at least 40° entered prospectively was utilized for this study. This included a total of 738 patients. Curve progression was analyzed overall and stratified by length of follow-up, curve location, and Risser stage at the time of presentation among other variables. Curve magnitude and Risser stage designations in this study were validated by performing a separate inter-and intrarater agreement study using four independent reviewers reading 50 patients' Cobb angle and Risser stage blinded in triplicate to examine the reliability of the study measurements. Results Annualized curve progression (ACP) averaged 6.3 ± 10.4°. ACP varied with length of follow-up: patients with up to 1 year of follow-up had an average ACP of 11.5 ± 17.0°, while those with 1-2 years had 8.2 ± 8.8°, and 2-5 years had 3.7 ± 4.1°, tapering off further from there. Risser stage 0 or 1 was associated with the highest ACP as compared to Risser stage 2-3 or 4-5. Intraclass correlation (ICC) values for Cobb angle measurement and Risser stage designations from four raters measuring 50 patients' measures, blinded and in triplicate, were all > 0.80, signifying a high degree of reliability within and between readers. Conclusions Annualized curve progression for 40° and greater curves was not linear over time; it was greatest immediately after a curve reaches 40° and tapered off over the next decade. Immature Risser stage at presentation was strongly associated with increasing ACP at all time frames. Level of evidence Prognostic Level I

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intermediate-term annualized curve progression of adolescent idiopathic scoliosis curves measuring 40° or greater

et al. 2020

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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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Curve Progression in Idiopathic Scoliosis.

Cited by 2 publications

References 5 publications

Intermediate-term annualized curve progression of adolescent idiopathic scoliosis curves measuring 40° or greater

Intermediate-term annualized curve progression of adolescent idiopathic scoliosis curves measuring 40° or greater

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

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