DiMeglio Alain, Canavese Federico, Charles Yann Philippe
Hospital Lapeyronie, Montpellier, Cedex, France.
J Pediatr Orthop. 2011 Jan-Feb;31(1 Suppl):S28-36. doi: 10.1097/BPO.0b013e318202c25d.
Growth in childhood and in puberty has a major influence on the evolution of spinal curvature. The yearly rate of increase in standing height and sitting height, bone age, and Tanner signs are essential parameters. Additionally, biometric measurements must be repeated every six months. Puberty is a turning point. The pubertal diagram is characterized by two phases: the first two years are a phase of acceleration, and the last three years is a phase of decelaration. Thoracic growth is the fourth dimension of the spine. Bone age is an essential parameter. Risser 0 covers two third of the pubertal growth. On the acceleration phase, olecranon evaluation is more precise than the hand. On the deceleration phase, the Risser sign must be completed by the hand maturation. A 30 degree curve at the very beginning of puberty has 100% risk of surgery. Any spinal, if progression is greater than 10 degree per year on the first two years of puberty the surgical risk is 100%.
儿童期和青春期的生长对脊柱弯曲的发展有重大影响。每年的站立身高、坐高、骨龄和坦纳征的增长速率是重要参数。此外，生物测量必须每六个月重复一次。青春期是一个转折点。青春期图表有两个阶段：前两年是加速阶段，后三年是减速阶段。胸廓生长是脊柱的第四个维度。骨龄是一个重要参数。Risser 0涵盖了青春期生长的三分之二。在加速阶段，鹰嘴评估比手部评估更精确。在减速阶段，Risser征必须通过手部成熟度来完善。青春期刚开始时30度的弯曲有100%的手术风险。任何脊柱侧弯，如果在青春期的头两年每年进展大于10度，手术风险为100%。
