The Iliac Apophysis and the Evolution of Curves in Scoliosis

Abstract

1. The belief that the cessation of spinal growth and curve progression coincides with the completion of growth in the iliac apophyses has been confirmed in a review of material from 224 cases. This applies also to paralytic curves. 2. In a high number of cases this ossification centre showed an asymmetrical development on the two sides of the pelvis. The appearance of a separate posterior centre of ossification is also common, and probably represents an advanced stage in the growth of the iliac apophysis. 3. Menarche and the growth of the apophyses of the vertebral bodies almost always occurred in advance of the iliac apophyses. They should be regarded as early signs of maturation, not reliable in the prognosis of curve progression. 4. The growth of the iliac apophysis appeared to be unaffected by poliomyelitis.

Radiographic versus ultrasound evaluation of the Risser Grade in adolescent idiopathic scoliosis: a prospective study of 46 patients

“…Various indicators for assessing maturity and spinal growth have been described in literature, such as chronologic age [16,23,31,40], the rip apophysis [14], the status of opened or closed triradiate cartilage [16], timing of menarche [14,23], peak height velocity [22,32,34], the assessment of the olecranon [8], calendar and skeletal age of the hand or wrist [12,14], the Risser sign [15,28], and electromyography [9]. The stage of ossification of the iliac apophysis (Risser sign) is the most commonly used method of determining skeletal maturation in patients with idiopathic scoliosis [4, 5, 11, 17, 19-21, 27, 30, 31, 37-39].…”

Progression in Untreated Idiopathic Scoliosis After end of Growth

“…Earlier, the general opinion was that idiopathic scoliosis did not progress after skeletal maturity (Zaoussis & James 1958). Collis & Ponseti (1969), however, found that many cases of scoliosis did not stop increasing after completion of iliac crest fusion.…”

Scoliosis elasticity assessed by manual traction:49 juvenile and adolescent idiopathic cases

“…The preoperative radiographic examination, included standing posteroanterior and lateral radiographs, posteroanterior radiographs in the standing position with lateral bending to both sides, anteroposterior radiographs in the supine position with traction, and an anteroposterior radiograph of the pclvis for determination of the Risser sign (Zaoussis andJames 1958, Moe 1987). With the exception of the radiographs taken during traction, posteroanterior radiographs were preferred so as to avoid undue amounts of radiation to the breasts.…”