Grivas Theodoros B, Vasiliadis Elias, Soultanis Konstantinos, Lykissas Marios, Katzouraki Galateia, Sekouris Nikolaos, Lykouris Dimitrios, Mazioti Christina, Mamzeri Aristea, Papagianni Despina, Potamiti Eleni, Kastrinis Alexandros, Theodosopoulos Evangelos
Department of Orthopedics & Traumatology, "Tzaneio" General Hospital of Piraeus, 185 36 Piraeus, Greece.
3rd Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, KAT Hospital, 145 61 Athens, Greece.
Med Sci (Basel). 2025 May 21;13(2):62. doi: 10.3390/medsci13020062.
This report provides a concise selective representative overview of the predictor factors for progression in Idiopathic Scoliosis (IS). The Cobb angle method, rib hump deformity, imaging and advanced techniques for assessing skeletal maturity serve as key elements in evaluating prognostic factors for IS progression based on the patient's age at diagnosis-particularly in Infantile Idiopathic Scoliosis (IIS), Juvenile Idiopathic Scoliosis (JIS), and Adolescent Idiopathic Scoliosis (AIS). The commonly used approaches for determining skeletal maturity include the assessment of the iliac apophysis and scoliosis curve deterioration, the Sanders skeletal maturity staging system, the distal radius and ulna (DRU) classification for predicting growth spurts and curve progression in IS, as well as the ossification of vertebral epiphyseal rings, the humeral head, and the calcaneal apophysis. Prognostic factors influencing IS progression are further discussed in relation to the patient's age at onset-whether in infancy, childhood, or adolescence-as well as in both untreated and braced AIS patients. Additionally, the apical convex rib-vertebra angle in AIS is explored as an indicator of progression. Predictors for curve progression at skeletal maturity are outlined, along with various models for forecasting IS deterioration. Lastly, the Rib and Segmental Rib Index, a rib cage deformity parameter, is introduced as a predictor of scoliosis progression. In conclusion, this concise and selective overview of predictor factors for progression in IS highlights the current understanding of IS progression factors. It also introduces the Rib and Segmental Rib Index-a rib cage deformity parameter-as a predictor of IS progression.
本报告简要、有选择性地代表性概述了特发性脊柱侧凸（IS）进展的预测因素。Cobb角法、肋骨隆凸畸形、评估骨骼成熟度的影像学及先进技术，是基于诊断时患者年龄评估IS进展预后因素的关键要素，尤其是在婴儿型特发性脊柱侧凸（IIS）、青少年型特发性脊柱侧凸（JIS）和青春期特发性脊柱侧凸（AIS）中。确定骨骼成熟度的常用方法包括髂骨骨骺评估和脊柱侧凸曲线恶化情况、Sanders骨骼成熟度分期系统、用于预测IS生长突增和曲线进展的桡骨远端和尺骨（DRU）分类，以及椎体骨骺环、肱骨头和跟骨骨骺的骨化情况。还将进一步讨论影响IS进展的预后因素与发病时患者年龄的关系，无论发病于婴儿期、儿童期还是青春期，以及未治疗和支具治疗的AIS患者的情况。此外，还探讨了AIS中的顶凸肋骨-椎体角作为进展指标的情况。概述了骨骼成熟时曲线进展的预测因素，以及各种预测IS恶化的模型。最后，引入了肋骨和节段肋骨指数（一种胸廓畸形参数）作为脊柱侧凸进展的预测指标。总之，这份关于IS进展预测因素的简要且有选择性的概述突出了目前对IS进展因素的理解。它还引入了肋骨和节段肋骨指数——一种胸廓畸形参数——作为IS进展的预测指标。
