Nemours Children's Health, 807 Children's Way, Jacksonville, FL, 32207, USA.
University of Missouri School of Medicine, Columbia, MO, USA.
Spine Deform. 2024 Nov;12(6):1657-1665. doi: 10.1007/s43390-024-00939-3. Epub 2024 Aug 12.
To define the risk of curve progression of idiopathic scoliosis (IS) to 35°, 40°, 45°, and 50° based on current curve magnitude and Sanders stage for boys and girls, using a large cohort of patients and encounters, to improve granularity and allow more accurate estimations to guide treatment.
Retrospective analysis of a prospectively collected scoliosis database. Generalized estimation equation logistic regression models estimated probabilities of curve progression to 35°, 40°, 45°, and 50° based on starting curve size and Sanders stage. Probabilities and their 95% confidence intervals were calculated for each combination of variables to each endpoint separately for boys and girls.
A total of 309 patients (80% girls) were included. Starting curve size and Sanders stage were significant predictors for progression in both sexes (all P ≤ 0.04). Higher starting curve sizes and lower Sanders stages were associated with greater odds of progression. Risk of progression was still present even at higher Sanders stages.
IS curves follow a predictable pattern, having more risk for progression when curves are larger and Sanders stages are smaller. Risk of curve progression is a spectrum based on these factors, indicating some risk of progression exists even for many smaller curves with higher Sanders stages. The improved granularity of this analysis compared to prior efforts may be useful for counseling patients about the risks of curve progression to various curve size endpoints and may aid shared decision-making regarding treatments.
Level III: retrospective cohort study.
基于当前曲线幅度和 Sanders 分期，为男孩和女孩定义特发性脊柱侧凸（IS）进展至 35°、40°、45°和 50°的风险，使用大量患者和就诊数据，以提高粒度并允许更准确的估计值来指导治疗。
回顾性分析前瞻性收集的脊柱侧凸数据库。广义估计方程逻辑回归模型根据起始曲线大小和 Sanders 分期估计进展至 35°、40°、45°和 50°的曲线进展概率。计算每个变量组合到每个终点的概率及其 95%置信区间，分别用于男孩和女孩。
共纳入 309 例患者（80%为女孩）。起始曲线大小和 Sanders 分期是两性进展的显著预测因素（均 P≤0.04）。较高的起始曲线大小和较低的 Sanders 分期与更大的进展几率相关。即使在较高的 Sanders 分期，进展的风险仍然存在。
IS 曲线遵循可预测的模式，曲线越大、Sanders 分期越小，进展的风险越大。曲线进展的风险是基于这些因素的连续谱，表明即使对于较高 Sanders 分期的许多较小曲线，也存在一定的进展风险。与之前的研究相比，这种分析的粒度提高可能有助于患者了解不同曲线大小终点的曲线进展风险，并有助于关于治疗的共同决策。
III 级：回顾性队列研究。
