Hori Yusuke, Kaymaz Burak, da Silva Luiz Carlos Almeida, Rogers Kenneth J, Yorgova Petya K, Gabos Peter G, Shah Suken A
Department of Orthopaedic Surgery, Nemours Children's Health, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Spine Deform. 2024 May;12(3):621-628. doi: 10.1007/s43390-024-00829-8. Epub 2024 Feb 19.
This study aimed to clarify the differences in spine and total body height growth and curve progression between Sanders maturation stage (SMS) 7A and 7B in patients with adolescent idiopathic scoliosis (AIS).
This retrospective case-control study involving patients with AIS at SMS 7 evaluated the differential gains in the spine (T1-S1) and total body height and curve progression between SMS 7A and 7B. A validated formula was used to calculate the corrected height, accounting for height loss due to scoliosis. A multivariable non-linear and logistic regression model was applied to assess the distinct growth and curve progression patterns between the SMS 7 subtypes, adjusting for potential confounders.
A total of 231 AIS patients (83% girls, mean age 13.9 ± 1.2 years) were included, with follow-up averaging 3.0 years. Patients at SMS 7A exhibited larger gains in spine height (9.9 mm vs. 6.3 mm) and total body height (19.8 mm vs. 13.4 mm) compared with SMS 7B. These findings remained consistent even after adjustments for curve magnitude. Non-linear regression models showed continued spine and total body height increases plateauing after 2 years, significantly greater in SMS 7A. More SMS 7A patients had curve progression over 10°, with an adjusted odds ratio of 3.31.
This study revealed that patients staged SMS 7A exhibited more spine and total body growth and a greater incidence of substantial curve progression than those at 7B. These findings imply that delaying brace discontinuation until reaching 7B could be beneficial, particularly for those with larger curves.
Level III (Case-control study).
本研究旨在阐明青少年特发性脊柱侧凸（AIS）患者桑德斯成熟阶段（SMS）7A和7B在脊柱及全身高度生长和曲线进展方面的差异。
这项回顾性病例对照研究纳入了处于SMS 7期的AIS患者，评估了SMS 7A和7B在脊柱（T1-S1）和全身高度方面的差异增长以及曲线进展情况。使用经过验证的公式计算校正后的身高，以考虑脊柱侧凸导致的身高损失。应用多变量非线性和逻辑回归模型评估SMS 7亚型之间不同的生长和曲线进展模式，并对潜在混杂因素进行调整。
共纳入231例AIS患者（83%为女孩，平均年龄13.9±1.2岁），平均随访3.0年。与SMS 7B相比，SMS 7A患者的脊柱高度增加幅度更大（9.9毫米对6.3毫米），全身高度增加幅度也更大（19.8毫米对13.4毫米）。即使在对曲线幅度进行调整后，这些结果仍然一致。非线性回归模型显示，脊柱和全身高度在2年后持续增加并趋于平稳，在SMS 7A中增加更为显著。更多的SMS 7A患者曲线进展超过10°，调整后的优势比为3.31。
本研究表明，处于SMS 7A期的患者比7B期患者表现出更多的脊柱和全身生长，以及更大的显著曲线进展发生率。这些发现意味着将支具停用推迟到7B期可能是有益的，特别是对于那些曲线较大的患者。
III级（病例对照研究）。
