Die wachsende Wirbelsäule

Abstract

Growth of the pediatric spine occurs in phases. The first 5 years of life are characterized by rapid growth. The lower extremities and trunk contribute equally to the entire growth by 50 % each. In the following years, until the onset of puberty, a steady but reduced rate of growth is observed. During these years a T1-S1 growth of only 1 cm per year can be detected and the spine contributes only one third to the entire growth. Puberty consists of an acceleration phase lasting 2 years. In the first year of this phase the growth peak of the extremities and in the following year the growth peak of the spine can be noticed. The ensuing deceleration phase of puberty lasts for 3 years. During that period the development of the Risser sign, menarche, and fusion of the trochanter epiphysis are taking place. Clinical parameters such as sitting height, standing height, and arm span may be used to evaluate growth. Important radiological parameters include the Risser sign, the determination of skeletal age according to Greulich and Pyle, and the T1-T12 height. The use of the olecranon method during the ascending phase of puberty can be recommended. Problems of the developing spine may include malformations, developmental disruptions or deformations. According to their manifestations they have a different prognosis, which can be estimated by knowledge of residual growth and the typical course of spinal growth in childhood.

Minimum 5-Year Results of Elongation Derotation Flexion Casting for Early Onset Scoliosis: The Story Is Not Over Until Skeletal Maturity

“…2). Stucker highlighted that the first 2 years of puberty consist of an acceleration phase of spinal growth, which also corresponded with the timing of decreased brace wear in our 3 patients 11 . With this knowledge, our data highlight the importance of consistent monitoring of scoliosis through skeletal maturity.…”

Influence of Lateral Sitting Wedges on the Rasterstereographically Measured Scoliosis Angle in Patients Aged 10–18 Years with Adolescent Idiopathic Scoliosis

“…The age group was set at 10–18 including those aged 18, with the knowledge that this exceeds the limit for diagnosing adolescent scoliosis [ 2 ]. But boys tend to have a longer growing period than girls, with a fusion of the pelvic apophysis around the age of 18 [ 46 ]. Furthermore, the clearest effect for lumbar scoliosis could be shown only for a small subgroup within the total collective (n = 7).…”

On growth and scoliosis

“…The natural growth of the healthy human spine is abundantly described in literature [25][26][27]. On average, it declines from more than 12 cm/year in the first year of life to about 2.3 cm/ year from age 6 until puberty.…”

“…Girls have a growth spurt at age 12-13 and boys at age 14-15, with stronger spinal growth in the second year of puberty. After that, there is a decline to zero at adulthood (data from Stücker [26]). The spine mainly grows in the vertebral bodies, lumbar more than thoracic more than cervical [27].…”