Chazono Masaaki, Obata Shintaro
Department of Orthopaedic Surgery, NHO Utsunomiya National Hospital, Tochigi, Japan.
Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Spine Surg Relat Res. 2021 Jan 12;5(4):244-251. doi: 10.22603/ssrr.2020-0176. eCollection 2021.
Since Little et al. first reported that peak height velocity (PHV) could be described as a reliable clinical marker for the prediction of remaining growth and curve progression of adolescent idiopathic scoliosis (AIS) in clinical practice, much attention has been paid to PHV as a possible predictor of curve progression in patients with AIS. However, PHV itself is only identified retrospectively, so its value is not available at the first outpatient clinic visit. Using the simplified skeletal maturity scale (SSMS) and the thumb ossification composite index (TOCI) staging systems, this study aims to assess skeletal maturity and predict height velocity (HV) in Japanese female patients with AIS.
This study involved 95 female patients with AIS, ranging from 9 to 17 years old. A standing AP radiograph of the entire spine and a hand radiograph were retrospectively obtained to establish the skeletal maturity stage in accordance with the SSMS and TOCI systems. Height measurements were recorded at each visit; HV was calculated as the height change (cm) divided by the time interval (years).
The TOCI stage rating increased identically to the SSMS stage rating increase. The chi-square test showed that there was a significant correlation between the two scoring systems (χ=720.4). The Cramer V correlation also demonstrated a very strong correlation (Cramer V=0.62). Regarding the relationship between HV and each SSMS and TOCI stage, HV decreased as SSMS and TOCI stages increased. equaled to 0.67 in both groups and displayed a strong correlation between HV and SSMS and TOCI stages.
These findings suggest that evaluation of the rate of HV using these radiological assessments is of supreme importance for determining the status of pubertal maturity and predicting the remaining amount of adolescent growth at the outpatient clinic visit.
自从利特尔等人首次报道在临床实践中，峰值身高速度（PHV）可作为预测青少年特发性脊柱侧凸（AIS）剩余生长和曲线进展的可靠临床指标以来，PHV作为AIS患者曲线进展的可能预测指标受到了广泛关注。然而，PHV本身只能通过回顾性确定，因此在首次门诊就诊时其价值尚不可用。本研究使用简化骨骼成熟度量表（SSMS）和拇指骨化综合指数（TOCI）分期系统，旨在评估日本AIS女性患者的骨骼成熟度并预测身高速度（HV）。
本研究纳入了95例年龄在9至17岁之间的AIS女性患者。回顾性获取整个脊柱的站立前后位X线片和手部X线片，以根据SSMS和TOCI系统确定骨骼成熟阶段。每次就诊时记录身高测量值；HV计算为身高变化（厘米）除以时间间隔（年）。
TOCI阶段评分与SSMS阶段评分的增加一致。卡方检验表明，两种评分系统之间存在显著相关性（χ=720.4）。克莱默V相关性也显示出非常强的相关性（克莱默V=0.62）。关于HV与每个SSMS和TOCI阶段之间的关系，HV随着SSMS和TOCI阶段的增加而降低。两组的 均等于0.67，显示出HV与SSMS和TOCI阶段之间存在强相关性。
这些发现表明，使用这些放射学评估来评估HV速率对于在门诊就诊时确定青春期成熟状态和预测青少年剩余生长量至关重要。
