The natural history of idiopathic scoliosis
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2005, Vol 7, Issue 1
Abstract
Background. The natural history of idiopathic scoliosis is a crucial issue in the planning and assessment of different treatment methods. This article presents the evaluation of scoliotic deformity in immature patients who have been in observation without any treatment. Material and methods. 159 patients (128 girls, 31 boys) were examined between 1971 and 2002. Skoliosis was diagnosed at a mean age of 6 years 4 months (range 2.1-8.10), and observation was concluded at a mean age of 16 years 11 months (range 14.6-20.3). The mean follow-up was 10 years 5 months. The prognostic factors analyzed were: age, sex, Cobb angle, Mehta angle, apical vertebral rotation, specific rotation, Risser test. The progression and regression of curvature was analyzed in different biological age periods, and was measured by calculating the difference in the Cobb angle on successive x-rays divided by the interval between x-rays.Results. The mean progression of curvature before age 5 was 5.7° per year; in the 6-10 age bracket, 2.3° per year; in the 11-15 age bracket, 7.4° per year; in the >15 age bracket, 0.3° per year. The mean progression for patients with Risser 1 was 8.8° per year; Risser 2, 7.3° per year; Risser 3, 5.1 per year; Risser 4, 2.1° per year; Risser 5, 0.3° per year. Conclusions. The progression of curvature in idiopathic scoliosis is variable, and is influenced by age. Knowledge of the natural history of idiopathic scoliosis is a crucial tool in predicting the development of spinal curvature. The Risser test and biological age are the only effective predictors of progression.
Authors and Affiliations
Aleksander Winiarski, Daniel Zarzycki, Arkadiusz Koniarski, Mariusz Kaliciński
Keywords
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