Zheng Jenny L, Li Ying, Hogue Grant, Johnson Megan, Anari Jason B, Baldwin Keith D
Orthopedic Surgery, Children's Hospital of Philadelphia, Philadelphia, USA.
Orthopedic Surgery, C.S. Mott Children's Hospital, Ann Arbor, USA.
Cureus. 2024 Apr 15;16(4):e58332. doi: 10.7759/cureus.58332. eCollection 2024 Apr.
Nonoperative care represents a cornerstone of adolescent idiopathic scoliosis (AIS) management, although no consensus exists for a minimal data set. We aimed to determine a consensus in critical data points to obtain during clinical AIS visits.
A REDCap-based survey was distributed to Pediatric Orthopedic Society of America (POSNA), Pediatric Spine Study Group (PSSG), and International Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT). Respondents ranked the importance of data points in history, physical examination, and bracing during AIS visits. Results: One hundred eighty-one responses were received (26% response rate), of which 86% were physicians and 14% were allied health professionals. About 80% of respondents worked at pediatric hospitals or pediatric spaces within adult hospitals, and 82% were academic, with the majority (57%) seeing 150+ unique AIS patients annually. Most respondents recommended six-month follow-up for patients under observation (60%) and bracing (54%). Most respondents (75%) considered family history and pain important (69%), with the majority (69%) asking about pain at every visit. Across all time points, Adam's forward bend test, shoulder level, sagittal contour, trunk shift, and curve stiffness were all considered critically important (>60%). At the first visit, scapular prominence, leg lengths, motor and neurological examination, gait, and iliac crest height were also viewed as critical. At the preoperative visit, motor strength and scapular prominence should also be documented. About 39% of respondents use heat sensors to monitor bracing compliance, and average brace wear since the prior visit was considered the most important (85%) compliance data point.
This study establishes recommendations for a 19-item minimum data set for clinical AIS evaluation, including history, physical exam, and bracing, to allow for future multicenter registry-based studies.
非手术治疗是青少年特发性脊柱侧凸（AIS）治疗的基石，尽管对于最小数据集尚无共识。我们旨在确定临床AIS就诊期间关键数据点的共识。
向美国小儿骨科学会（POSNA）、小儿脊柱研究组（PSSG）和国际脊柱侧凸矫形与康复治疗协会（SOSORT）发放了基于REDCap的调查问卷。受访者对AIS就诊期间病史、体格检查和支具治疗中数据点的重要性进行了排名。
共收到181份回复（回复率26%），其中86%为医生，14%为专职医疗人员。约80%的受访者在儿科医院或成人医院的儿科科室工作，82%为学术人员，大多数（57%）每年诊治150多名独特的AIS患者。大多数受访者建议对观察期患者（60%）和支具治疗患者（54%）进行六个月随访。大多数受访者（75%）认为家族史和疼痛很重要（69%），大多数（69%）每次就诊都询问疼痛情况。在所有时间点，亚当前屈试验、肩部水平、矢状面轮廓、躯干偏移和曲线僵硬程度均被认为至关重要（>60%）。在首次就诊时，肩胛突出、腿长、运动和神经检查、步态以及髂嵴高度也被视为关键因素。在术前就诊时，还应记录运动强度和肩胛突出情况。约39%的受访者使用热传感器监测支具佩戴依从性，自上次就诊以来的平均支具佩戴时间被认为是最重要的（85%）依从性数据点。
本研究为临床AIS评估建立了一个19项最小数据集的建议，包括病史、体格检查和支具治疗，以便未来开展基于多中心注册的研究。
