Zapata Karina A, Sucato Daniel J, Lee Mark C, Jo Chan-Hee
Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA.
Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, TX 75219, USA.
Spine Deform. 2019 Nov;7(6):870-874. doi: 10.1016/j.jspd.2019.02.012.
Retrospective review.
To evaluate the incidence of adolescent idiopathic scoliosis (AIS) curve progression and brace prescription in skeletally immature patients (Risser 0 to Risser 1) with curves 15°-24°.
Many skeletally immature patients with mild AIS ask about the likelihood of curve progression. No studies have answered these questions.
The charts and radiographs of 302 consecutive patients with curves 15°-24° at initial visit, Risser 0 to Risser 1, were reviewed until skeletal maturity (≥Risser 4) or surgery. Curves averaged 19.1° ± 2.9° at initial visit. The Risser grade was 0 in 247 patients (82%) and 1 in 55 patients (18%). Patients who were Risser 0 were compared with those who were Risser 1, curves 15°-19° were compared with curves 20°-24°.
The majority of patients demonstrated curve progression ≥5° (65%). Patients who were Risser 0 did not progress significantly more than patients who were Risser 1 (10° vs. 8°) (p = .22). Patients with curves 20°-24° did not progress significantly more than patients with curves 15°-19° (10° vs. 9°) (p = .65).
Curve progression for small curves (15°-19°) is similar to curves between 20° and 24°. Close observation or perhaps early intervention for these patients is necessary. These data may suggest a paradigm shift to earlier brace initiation and call for early treatment in small curves.
Level II.
回顾性研究。
评估骨骼未成熟（Risser 0至Risser 1）、侧弯角度为15° - 24°的青少年特发性脊柱侧弯（AIS）患者侧弯进展的发生率及支具治疗的处方情况。
许多骨骼未成熟的轻度AIS患者询问侧弯进展的可能性。尚无研究回答这些问题。
回顾302例初诊时侧弯角度为15° - 24°、Risser 0至Risser 1的连续患者的病历和X线片，直至骨骼成熟（≥Risser 4）或接受手术。初诊时侧弯平均角度为19.1° ± 2.9°。247例患者（82%）Risser分级为0，55例患者（18%）Risser分级为1。将Risser 0级患者与Risser 1级患者进行比较，15° - 19°侧弯患者与20° - 24°侧弯患者进行比较。
大多数患者侧弯进展≥5°（65%）。Risser 0级患者的进展并不显著高于Risser 1级患者（10°对8°）（p = 0.22）。20° - 24°侧弯患者的进展并不显著高于15° - 19°侧弯患者（10°对9°）（p = 0.65）。
小角度侧弯（15° - 19°）的进展与20°至24°侧弯相似。对这些患者进行密切观察或早期干预是必要的。这些数据可能提示治疗模式向更早使用支具转变，并呼吁对小角度侧弯进行早期治疗。
二级。
