成熟度指标与青少年特发性脊柱侧凸：桑德斯成熟度评估量表的评估。
Maturity Indicators and Adolescent Idiopathic Scoliosis: Evaluation of the Sanders Maturity Scale.
机构信息
Department of Orthopedic Surgery, Nemours Children's Specialty Care, Jacksonville, FL.
Pediatric Orthopaedic Associates, Woodstock, GA.
出版信息
Spine (Phila Pa 1976). 2018 Apr 1;43(7):E406-E412. doi: 10.1097/BRS.0000000000002483.
STUDY DESIGN
Retrospective review.
OBJECTIVE
To determine the correlation between the Sanders Maturity Scale (SMS) and Risser stages, between both systems and menarche, and whether Risser can be used to predict SMS.
SUMMARY OF BACKGROUND DATA
Predicting curve progression is critical to understanding adolescent idiopathic scoliosis and making treatment recommendations. The SMS is a better predictor of the curve acceleration phase of growth than the Risser stage. However, Scoliosis Research Society bracing criteria utilize the Risser stage and menarche.
METHODS
Consecutive female patients, 8 to 16 years old, evaluated for idiopathic scoliosis or spinal asymmetry over a 31-month period were included. Main curve size, Risser stage, menarchal status, and SMS stage were recorded for each encounter, and analyzed using Spearman rank correlation and regression models.
RESULTS
Six hundred fifty-six encounters (452 patients) were included with SMS staging, including 402 encounters that included menarchal data. The correlation between the Risser stage and the SMS stage was 0.9031 (P < 0.0001). However, ranges for the SMS at each Risser stage were large. Correlation between Risser stage and menarche was 0.7327 (P < 0.0001), and between SMS and menarche was 0.8355 (P < 0.0001). Eighty-five percent of SMS 3 patients were Risser 0, with or without open triradiate cartilages. Eighty-one percent of Risser 1 patients were SMS 4 or greater.
CONCLUSION
When assessing maturity in idiopathic scoliosis, SMS correlates strongly with Risser stages, and both SMS and Risser correlate with menarche. However, Risser stage is a poor predictor of the exact SMS stage for individual patients due to the large ranges. The majority of patients who are ≥Risser 1 have passed the curve acceleration phase of growth. Developing brace criteria based upon the SMS stage may allow more accurate predictions regarding which patients will benefit from bracing.
LEVEL OF EVIDENCE
研究设计
回顾性研究。
目的
确定桑德斯成熟度量表（SMS）与 Risser 分期之间的相关性，以及这两个系统与初潮之间的相关性，以及 Risser 分期是否可用于预测 SMS。
背景资料总结
预测曲线进展对于理解青少年特发性脊柱侧凸并提出治疗建议至关重要。SMS 是生长加速阶段曲线的更好预测指标，而 Risser 分期则不是。然而，脊柱侧凸研究学会支具标准使用 Risser 分期和初潮。
方法
连续入组了 31 个月期间因特发性脊柱侧凸或脊柱不对称而接受评估的 8 至 16 岁女性患者。记录每次就诊时的主曲线大小、Risser 分期、初潮状态和 SMS 分期，并使用 Spearman 秩相关和回归模型进行分析。
结果
共纳入 656 次就诊（452 例患者），其中包括 402 次就诊时包含初潮数据的 SMS 分期。Risser 分期与 SMS 分期之间的相关性为 0.9031（P<0.0001）。然而，SMS 分期在每个 Risser 分期的范围都很大。Risser 分期与初潮之间的相关性为 0.7327（P<0.0001），SMS 分期与初潮之间的相关性为 0.8355（P<0.0001）。85%的 SMS 3 期患者为 Risser 0 期，无论是否有开放三放射状软骨。81%的 Risser 1 期患者为 SMS 4 期或更高。
结论
在评估特发性脊柱侧凸的成熟度时，SMS 与 Risser 分期密切相关，SMS 和 Risser 分期都与初潮相关。然而，由于范围较大，Risser 分期是个体患者 SMS 分期的预测指标较差。大多数 Risser 分期≥1 的患者已经过了曲线生长加速阶段。根据 SMS 分期制定支具标准可能更准确地预测哪些患者将受益于支具治疗。
证据等级
2。
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