Progression of the curve in boys who have idiopathic scoliosis.

Karol, Lori A.; Johnston, Charles E.; Browne, Richard; Madison, Michael

doi:10.2106/00004623-199312000-00010

Cited by 93 publications

(52 citation statements)

References 6 publications

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“…However, in male AIS patients, neither standing height nor arm span was identified as independently associated with curve severity. These data may help explain the basis for the lower incidence of curve progression in male AIS patients compared with female patients [11,18,34].…”

Section: Discussionmentioning

confidence: 89%

“…Although the etiology of AIS is unclear, the natural history of these patients has been well documented, and significant sexual dimorphism noted [25,35]. A higher tendency toward curve progression has been reported in female AIS patients compared with male patients during puberty [4,11,38,39]. The female-to-male ratio for the prevalence of AIS with mild curvature (a Cobb angle between 10°and 19°) was nearly unity (1.4:1).…”

Section: Introductionmentioning

confidence: 99%

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Abnormal anthropometric measurements and growth pattern in male adolescent idiopathic scoliosis

et al. 2011

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Abnormal anthropometric measurements and growth pattern in male adolescent idiopathic scoliosis

et al. 2011

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“…The incidence of progression in different reports varies according to the criteria of progression, inclusion of patients undergoing treatment, and length of follow-up [5,7,9,11,14,20]. In a prospective screening study, Brooks et al [1] reported a 5% incidence of progression in 134 children with a scoliosis of 5°or more, and a spontaneous improvement in 22%.…”

Section: Discussionmentioning

confidence: 99%

Assessment of curve progression in idiopathic scoliosis

Soucacos

Zacharis

Gelalis

et al. 1998

European Spine Journal

108

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IntroductionA major concern of orthopedic surgeons in managing children with idiopathic scoliosis with a minor curvature is identifying how many and which curves will progress to severe deformities requiring treatment [1, 3-12, 14, 15]. Accurate identification of curves destined to progress requires a clear understanding of the natural history of idiopathic scoliosis. In this regard, school screening has been a powerful tool for the identification of children who may have scoliosis, as well as for providing information on the course of the disease over time [10, 11, 15, 17-19, 21, 22]. The vast majority of the children, however, show no spinal deformity, and of the scoliotic curves detected through school screening, only a percentage are destined to progress to clinical significance. Various factors have been associated with curve progression, although it is not clear to what extent they can be used in predicting the course of the natural history of the scoliotic curve. As a Abstract In a 5-year prospective study on idiopathic scoliosis, an attempt was made to elucidate the natural history of the disease and to determine which factors contribute to curve progression. A total of 85,622 children were examined for scoliosis in a prospective school screening study carried out in northwestern and central Greece. Curve progression was studied in 839 of the 1,436 children with idiopathic scoliosis of at least 10°detected from the school screening program. Each child was followed clinically and roentgenographically for one to four follow-up visits for a mean of 3.2 years. Progression of the scoliotic curve was recorded in 14.7% of the children. Spontaneous improvement of at least 5°was observed in 27.4% of them, with 80 children (9.5%) demonstrating complete spontaneous resolution. Eighteen percent of the patients remained stable, while the remaining patients demonstrated nonsignificant changes of less than 5°in curve magnitude. A strong association was observed between the incidence of progression and the sex of the child, curve pattern, maturity, and to a lesser extent age and curve magnitude. More specifically, the following were associated with a high risk of curve progression: sex (girls); curve pattern (right thoracic and double curves in girls, and right lumbar curves in boys); maturity (girls before the onset of menses); age (time of pubertal growth spurt); and curve magnitude (≥ 30°). On the other hand, left thoracic curves showed a weak tendency for progression. In conclusion, the findings of the present study strongly suggest that only a small percentage of scoliotic curves will undergo progression. The pattern of the curve according to curve direction and sex of the child was found to be a key indicator of which curves will progress.

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“…Similarly, Nachemson and Peterson [32] demonstrated 66% of observed patients with idiopathic scoliosis curves measuring 20°to 35°progressed 6°. Karol et al [23] found 32% of boys presenting with a curve of at least 25°and all Risser stages progressed 10°or more. Boys tend to have curves that progress beyond Risser 4 into late adolescence, whereas girls' growth has begun to decelerate by this time.…”

Section: Natural Historymentioning

confidence: 99%

“…Bracing should continue until growth has stopped, indicated by unchanged height measured consecutively 6 months apart, Risser sign 4 (females) or 5 (males), postmenarchal 18 to 24 months, or skeletal maturity on bone age determination [49]. Although Karol has stated bracing in boys should be continued until Risser 5 as a result of the prolonged growth period during the Risser 4 phase, 46% of her patients had curves progress to surgical correction despite brace wear [23]. She found nearly 80% of curves will progress when not braced compared with similarly braced patients and are four times as likely to require spinal instrumentation and fusion, whereas compliant patients will show minimal progression and most likely not require surgery.…”

Section: Treatment Recommendationsmentioning

confidence: 99%

Brace Management in Adolescent Idiopathic Scoliosis

Schiller

Thakur

Eberson

2010

Clinical Orthopaedics &Amp; Related Research

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Skeletally immature patients with adolescent idiopathic scoliosis are at risk for curve progression. Although numerous nonoperative methods have been attempted, including physical therapy, exercise, massage, manipulation, and electrical stimulation, only bracing is effective in preventing curve progression and the subsequent need for surgery. Brace treatment is initiated as either full-time (TLSO, Boston) or nighttime (Charleston, Providence) wear, although patient compliance with either mode of bracing has been a documented problem. We review the natural history of adolescent idiopathic scoliosis, identify the risks for curve progression, describe the types of braces available for treatment, and review the indications for and efficacy of brace treatment.

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Progression of the curve in boys who have idiopathic scoliosis.

Cited by 93 publications

References 6 publications

Abnormal anthropometric measurements and growth pattern in male adolescent idiopathic scoliosis

Abnormal anthropometric measurements and growth pattern in male adolescent idiopathic scoliosis

Assessment of curve progression in idiopathic scoliosis

Brace Management in Adolescent Idiopathic Scoliosis

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