Lara Taylor, Astur Nelson, Jones Tamekia L, Perake Vinayak, Moisan Alice, Warner William C, Sawyer Jeffery R, Kelly Derek M
Departments of Pediatrics and Preventive Medicine, Children's Foundation Research Institute, University of Tennessee Health Science Center, 50 N. Dunalp, R 461R, Memphis, TN 38103, USA.
Instituto Astur, Av. Pacaembu, 1024, CEP 01234-000, Pacaembu, São Paulo, SP, Brasil.
Spine Deform. 2017 Jul;5(4):250-254. doi: 10.1016/j.jspd.2017.01.013.
Retrospective clinical cohort study.
To determine if certain risk factors (age, curve magnitude, skeletal maturity, gender, and curve pattern) traditionally associated with curve progression and surgical intervention in the general population apply equally to African Americans.
Currently, information is limited on the role that a patient's race plays in the risk of curve progression of adolescent idiopathic scoliosis (AIS), and existing studies have conflicting results.
Retrospective search of records identified patients who were African American, had been diagnosed with AIS, had a major curve Cobb angle of 10 degrees or more, and had at least two clinical visits with spinal radiographs at least 90 days apart to determine the risk factors for surgical treatment, and 2 years apart to determine the risk factors for curve progression. Patients with a medical condition likely to cause scoliosis were excluded.
Of 738 African American patients with AIS, 223 were assessed for surgical risk factors, and 72 were assessed for curve progression risk factors. Fifty-six (29.17%) had progression of the major coronal curve, and 38 (17.04%) underwent surgery. Age at presentation and curve magnitude at presentation were significant risk factors for surgical intervention. Curve magnitude at presentation was a significant risk factor for curve progression. No significant relationships were found for gender or curve type as they relate to surgical intervention or curve progression.
Age and curve magnitude at presentation were significantly associated with surgery, as is true in other scoliosis populations. Curve magnitude at presentation was associated with curve progression. In contrast to studies in other populations, however, no significant association was observed between curve progression and age at presentation, curve type, or gender, or between surgery and curve type or gender.
Level III, prognostic cohort study.
回顾性临床队列研究。
确定在一般人群中传统上与脊柱侧弯进展及手术干预相关的某些风险因素（年龄、侧弯程度、骨骼成熟度、性别和侧弯类型）是否同样适用于非裔美国人。
目前，关于患者种族在青少年特发性脊柱侧弯（AIS）侧弯进展风险中所起作用的信息有限，现有研究结果相互矛盾。
通过回顾性检索记录，确定为非裔美国人、被诊断为AIS、主弯Cobb角为10度或更大、且至少有两次间隔至少90天的脊柱X光临床检查以确定手术治疗风险因素，以及间隔两年的检查以确定侧弯进展风险因素的患者。排除可能导致脊柱侧弯的内科疾病患者。
在738例非裔美国AIS患者中，223例接受了手术风险因素评估，72例接受了侧弯进展风险因素评估。56例（29.17%）主冠状位侧弯有进展，38例（17.04%）接受了手术。就诊时的年龄和就诊时的侧弯程度是手术干预的显著风险因素。就诊时的侧弯程度是侧弯进展的显著风险因素。未发现性别或侧弯类型与手术干预或侧弯进展之间存在显著关系。
就诊时的年龄和侧弯程度与手术显著相关，这在其他脊柱侧弯人群中也是如此。就诊时的侧弯程度与侧弯进展相关。然而，与其他人群的研究不同，未观察到侧弯进展与就诊时的年龄、侧弯类型或性别之间，或手术与侧弯类型或性别之间存在显著关联。
三级，预后队列研究。
