Liu D, Xia S Q, Shi B, Shi B L, Liu Z, Sun X, Qiu Y, Zhu Z Z
Department of Spinal Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China.
Zhonghua Yi Xue Za Zhi. 2018 Nov 6;98(41):3315-3319. doi: 10.3760/cma.j.issn.0376-2491.2018.41.004.
To evaluate the predictive value of thumb ossification composite index (TOCI) for growth potential in female adolescent idiopathic scoliosis (AIS) patients and to analyze its correlation with several other indicators of growth potential. A retrospective review was conducted on 45 girls with AIS who underwent standard bracing treatment between October 2006 and August 2013 in Nanjing Drum Tower Hospital. All patients were regularly followed up with an interval of 3-6 months until brace weaning. At each visit, the following data were collected and recorded: chronologic age, stage of menses, standing height, Cobb angle of main curve, TOCI score, digital skeletal age (DSA) score and radius, ulna and small bones (RUS) score. The height velocity (HV) at each visit were calculated. The correlations analysis between TOCI and other indicators including DSA scores and RUS scores were studied. The average age at initial visit was (10.9±1.3) years. The mean age of menarche was (12.6±1.3) years. The mean peak height velocity (PHV) was (7.5±1.5) cm/year and the mean age of PHV was (12.0±0.9) years. A total of 71.8% AIS girls attained their PHV at TOCI 5. The Spearman correlation analysis showed that TOCI was highly correlated with the DSA and RUS scores (=0.95 and 0.96, both <0.001). Chi-square test showed that TOCI 5 accurately predicted the occurrence of PHV (Cramer V=0.531, =0.007). The TOCI 5 indicates high HV and high growth potential in AIS patients with bracing treatment. TOCI can thus serve as a good indicator for growth potential in braced AIS girls.
评估拇指骨化综合指数(TOCI)对女性青少年特发性脊柱侧凸(AIS)患者生长潜能的预测价值,并分析其与其他几种生长潜能指标的相关性。对2006年10月至2013年8月在南京鼓楼医院接受标准支具治疗的45例AIS女孩进行回顾性研究。所有患者均定期随访,间隔3 - 6个月,直至支具停用。每次随访时,收集并记录以下数据:实际年龄、月经分期、站立身高、主弯Cobb角、TOCI评分、数字骨龄(DSA)评分以及桡骨、尺骨和小骨(RUS)评分。计算每次随访时的身高速度(HV)。研究TOCI与其他指标(包括DSA评分和RUS评分)之间的相关性分析。首次就诊的平均年龄为(10.9±1.3)岁。月经初潮的平均年龄为(12.6±1.3)岁。平均峰值身高速度(PHV)为(7.5±1.5)cm/年,PHV的平均年龄为(12.0±0.9)岁。71.8%的AIS女孩在TOCI为5时达到其PHV。Spearman相关性分析表明,TOCI与DSA和RUS评分高度相关(分别为=0.95和0.96,均<0.001)。卡方检验表明,TOCI为5能准确预测PHV的发生(Cramer V = 0.531,=0.007)。TOCI为5表明接受支具治疗的AIS患者具有较高的HV和较高的生长潜能。因此,TOCI可作为接受支具治疗的AIS女孩生长潜能的良好指标。