How do we follow-up patients with adolescent idiopathic scoliosis? Recommendations based on a multicenter study on the distal radius and ulna classification

European spine journal

article

Yusuke Yamamoto¹  Hideki Shigematsu¹  Prudence Wing Hang Cheung²  Akinori Okuda¹  Sachiko Kawasaki¹  Yasuhito Tanaka¹  Jason Pui Yin Cheung² 

[1] Department of Orthopaedic Surgery, Nara Medical University;Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital

关键词: Adolescent idiopathic scoliosis;    Distal radius and ulna classifcation;    Bone age;    Cobb angle;    Curve progression;    Follow-up duration;   

DOI  :  10.1007/s00586-020-06441-4

来源: Springer

【 摘 要 】

To determine the capability of the distal radius and ulna (DRU) classification for predicting the scoliosis progression risk within 1 year in patients with adolescent idiopathic scoliosis (AIS) and to develop simple recommendations for follow-up durations. Medical records of patients with AIS at two tertiary scoliosis referral centers were retrospectively reviewed for their DRU classification and major curve Cobb angles. Baseline DRU grades and Cobb angles with subsequent 1-year follow-up curve magnitudes were studied for scoliosis progression, which was defined as exacerbation of the Cobb angle by ≥ 6°. The relationship between DRU classification and scoliosis progression risk within 1 year was investigated. Patients were divided into three groups according to the Cobb angle (10°–19°, 20°–29°, ≥ 30°). Of the 205 patients with 283 follow-up visits, scoliosis progression occurred in 86 patients (90 follow-up visits). Radius and ulna grades were significantly related to scoliosis progression (p  80% of patients within 1 year. Curve progression was less likely for grades R9 and U7. Most patients with more mature DRU grades did not experience progression, even with Cobb angles ≥ 30°. With R6, R7, and U5, scoliosis may progress within a short period; therefore, careful follow-up with short intervals within 6 months is necessary. R9 and U7 may allow longer 1-year follow-up intervals due to the lower progression risk.

【 授权许可】

Unknown