Current models to understand the onset and progression of scoliotic deformities in adolescent idiopathic scoliosis: a systematic review

Meiring, A R; Kater, Esther P. de; Stadhouder, Agnita; Royen, Barend J. van; Breedveld, Paul; Smit, Theo H.

doi:10.1007/s43390-022-00618-1

Cited by 3 publications

(1 citation statement)

References 93 publications

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“…While there is no universally accepted theory explaining the pathogenesis of AIS, anterior column overgrowth is a frequently studied phenomenon, [69][70][71][72][73][74][75] with ongoing debate surrounding the cause-effect relationship with wedging and rotation. 76,77 Our included studies also reported sagittal wedging in lower junctional vertebrae and discs, which was associated with increases in Cobb angle. 49,51 Among thoracic, thoracolumbar, and lumbar curves, thoracic hypokyphosis was consistently observed in 3D studies.…”

Section: Sagittal Deformitymentioning

confidence: 88%

3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

Wan,

Wong,

et al. 2024

Bone Jt Open

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AimsThis systematic review aims to identify 3D predictors derived from biplanar reconstruction, and to describe current methods for improving curve prediction in patients with mild adolescent idiopathic scoliosis.MethodsA comprehensive search was conducted by three independent investigators on MEDLINE, PubMed, Web of Science, and Cochrane Library. Search terms included “adolescent idiopathic scoliosis”,“3D”, and “progression”. The inclusion and exclusion criteria were carefully defined to include clinical studies. Risk of bias was assessed with the Quality in Prognostic Studies tool (QUIPS) and Appraisal tool for Cross-Sectional Studies (AXIS), and level of evidence for each predictor was rated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. In all, 915 publications were identified, with 377 articles subjected to full-text screening; overall, 31 articles were included.ResultsTorsion index (TI) and apical vertebral rotation (AVR) were identified as accurate predictors of curve progression in early visits. Initial TI > 3.7° and AVR > 5.8° were predictive of curve progression. Thoracic hypokyphosis was inconsistently observed in progressive curves with weak evidence. While sagittal wedging was observed in mild curves, there is insufficient evidence for its correlation with curve progression. In curves with initial Cobb angle < 25°, Cobb angle was a poor predictor for future curve progression. Prediction accuracy was improved by incorporating serial reconstructions in stepwise layers. However, a lack of post-hoc analysis was identified in studies involving geometrical models.ConclusionFor patients with mild curves, TI and AVR were identified as predictors of curve progression, with TI > 3.7° and AVR > 5.8° found to be important thresholds. Cobb angle acts as a poor predictor in mild curves, and more investigations are required to assess thoracic kyphosis and wedging as predictors. Cumulative reconstruction of radiographs improves prediction accuracy. Comprehensive analysis between progressive and non-progressive curves is recommended to extract meaningful thresholds for clinical prognostication.Cite this article: Bone Jt Open 2024;5(3):243–251.

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Section: Sagittal Deformitymentioning

confidence: 88%

3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

Wan,

Wong,

et al. 2024

Bone Jt Open

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Computer Modeling of the Thoracic Spine in Children: Assessment of the Contribution of Rectified Kyphosis in the Possible Development of Adolescent Idiopathic Scoliosis

Brandão,

Greco,

Aroeira

2024

CCS

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Introduction: Adolescent Idiopathic Scoliosis is a spinal deformity. Its development can be linked to hypokyphosis in the thoracic region. Objective: The present study proposed to investigate, through the finite element method, the biomechanics of the immature thoracic spine segment T5-T10 in normal and rectified kyphosis under axial load, flexion and extension. Materials and Methods: Intervertebral discs were modeled as hyperelastic material and vertebral bone as elastic linear material. The bone was divided into trabecular and cortical regions. Furthermore, discs were divided into nucleus pulposus and annulus fibrous. Results: Results indicate greater instability of rectified segments with larger strain and displacements, mainly under extension. Conclusion: It was concluded that the rectified model is predisposed to the development of scoliosis since higher deformations and displacements in this condition were observed, going in favor of the assumption that this factor would be one of the causes of Adolescent Idiopathic Scoliosis.

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Prognostic model development for risk of curve progression in adolescent idiopathic scoliosis: a prospective cohort study of 127 patients

Dufvenberg,

Charalampidis,

Diarbakerli

et al. 2024

ActaO

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Background and purpose: The study’s purpose was to develop and internally validate a prognostic survival model exploring baseline variables for adolescent idiopathic scoliosis curve progression.Methods: A longitudinal prognostic cohort analysis was performed on trial data (n = 135) including girls and boys, Cobb angle 25–40°, aged 9–17 years, remaining growth > 1 year, and previously untreated. Prognostic outcome was defined as curve progression of Cobb angle of > 6° prior to skeletal maturity. 34 candidate prognostic variables were tested. Time-to-event was measured with 6-month intervals. Cox proportional hazards regression survival model (CoxPH) was used for model development and validation in comparison with machine learning models (66.6/33.3 train/test data set). The models were adjusted for treatment exposure.Results: The final primary prognostic model included 127 patients, predicting progress with acceptable discriminative ability (concordance = 0.79, 95% confidence interval [CI] 0.72–0.86). Significant prognostic risk factors were Risser stage of 0 (HR 4.6, CI 2.1–10.1, P < 0.001), larger major curve Cobb angle (HRstandardized 1.5, CI 1.1–2.0, P = 0.005), and higher score on patient-reported pictorial Spinal Appearance Questionnaire (pSAQ) (HRstandardized 1.4, CI 1.0–1.9, P = 0.04). Treatment exposure, entered as a covariate adjustment, contributed significantly to the final model (HR 3.1, CI 1.5–6.0, P = 0.001). Sensitivity analysis displayed that CoxPH maintained acceptable discriminative ability (AUC 0.79, CI 0.65–0.93) in comparison with machine learning algorithms.Conclusion: The prognostic model (Risser stage, Cobb angle, pSAQ, and menarche) predicted curve progression of > 6° Cobb angle with acceptable discriminative ability. Adding patient report of the pSAQ may be of clinical importance for the prognosis of curve progression.

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Current models to understand the onset and progression of scoliotic deformities in adolescent idiopathic scoliosis: a systematic review

Abstract: 1 Important note To cite this publication, please use the final published version (if applicable). Please check the document version above.

Cited by 3 publications

References 93 publications

3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

3D prediction of curve progression in adolescent idiopathic scoliosis based on biplanar radiological reconstruction

Computer Modeling of the Thoracic Spine in Children: Assessment of the Contribution of Rectified Kyphosis in the Possible Development of Adolescent Idiopathic Scoliosis

Prognostic model development for risk of curve progression in adolescent idiopathic scoliosis: a prospective cohort study of 127 patients

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