Woods Natalie, Wittmeier Kristy, Mulder Kathy, Dufault Brenden, Black Brian
Physiotherapy Department, Health Sciences Centre Winnipeg - Shared Health, Winnipeg, MB, Canada.
Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
Orthop Res Rev. 2022 May 9;14:149-155. doi: 10.2147/ORR.S359394. eCollection 2022.
To evaluate the relationship between body mass index (BMI) and spinal curvature in patients presenting with idiopathic scoliosis at a major pediatric tertiary care centre.
Retrospective chart review (2015-2019). Data extracted from patient's first visit included age, sex, height, weight, spinal curvature (magnitude, location), referral source, physical activity participation (yes/no), pain (yes/no). Demographics were analyzed descriptively. The relationship between BMI and spinal curve magnitude was analyzed using Spearman correlation coefficient. Linear regression was applied to determine the relationship between BMI, curve magnitude, and curve location. Exploratory univariate analyses were conducted for BMI and referral source, pain, and skeletal maturity, and physical activity and pain.
A total of 206 patient charts were included (177 females, 29 males). Patients presented with double major (41.3%), thoracic (26.7%), thoracolumbar (22.8%), and lumbar (9.2%) curves. Mean (SD) BMI percentile was 48.3 (30.5). No relationship existed between BMI percentile and curve magnitude with curve locations combined. However, a test for interaction revealed a positive relationship between BMI percentile and curve magnitude for adolescents with double major curves, and a negative relationship for adolescents with thoracic curves. Exploratory analyses suggested a relationship between BMI percentile and presence of pain, and between referral source and curve magnitude. No relationship was observed between BMI and skeletal maturity, or physical activity and pain.
The relationship between BMI varied by curve location within this cohort, in which most patients presented with a BMI <85th percentile. Findings highlight the importance of sensitive history taking and careful physical examination for early detection of scoliosis.
评估在一家大型儿科三级护理中心就诊的特发性脊柱侧凸患者的体重指数（BMI）与脊柱侧弯之间的关系。
回顾性病历审查（2015 - 2019年）。从患者首次就诊时提取的数据包括年龄、性别、身高、体重、脊柱侧弯情况（程度、位置）、转诊来源、体育活动参与情况（是/否）、疼痛情况（是/否）。对人口统计学数据进行描述性分析。使用Spearman相关系数分析BMI与脊柱侧弯程度之间的关系。应用线性回归来确定BMI、侧弯程度和侧弯位置之间的关系。对BMI与转诊来源、疼痛和骨骼成熟度，以及体育活动与疼痛进行探索性单因素分析。
共纳入206份患者病历（177名女性，29名男性）。患者出现双主弯（41.3%）、胸弯（26.7%）、胸腰弯（22.8%）和腰弯（9.2%）。平均（标准差）BMI百分位数为48.3（30.5）。BMI百分位数与综合曲线位置的曲线程度之间不存在关系。然而，交互作用检验显示，双主弯青少年的BMI百分位数与曲线程度呈正相关，而胸弯青少年则呈负相关。探索性分析表明BMI百分位数与疼痛存在之间、转诊来源与曲线程度之间存在关系。未观察到BMI与骨骼成熟度，或体育活动与疼痛之间的关系。
在该队列中，BMI与曲线位置的关系各不相同，其中大多数患者的BMI低于第85百分位数。研究结果强调了详细病史采集和仔细体格检查对早期发现脊柱侧凸的重要性。
