Abstract
Purpose: The purpose of this study was to detect any possible prognostic factors which may affect the spinal deformity progression and their relationships in idiopathic scoliosis.
Methods: The stereo-radiograph of whole spine at each visit was reconstructed with two spinal x-ray images in PA 0° and 20° using DLT techniques. Sequential data sets with 3, 4 or 5 successive values of prognostic factors were extracted from 111 consecutive patients (12.3±2.3 yrs, Cobb angle 30.2±12.4°) and separated into the stable and the progressed groups, based on a progression threshold of Cobb angle 5° and 10°. The prognostic factors included gender, curve pattern, age, curve magnitude, apex location, lateral deviation and spinal growth. Effects of those factors were conducted by comparing them between two groups (statistical significances p< 0.05) and the relationships were determined using Pearson’s correlation coefficient (r).
Results: The progressed subjects were predominantly females (50–79%) with double curves. Double curves progressed on both curves RT and LL at the same times and alternatively. There were no significant differences of initial ages and ages with maximum curve magnitudes between two groups. Initial and maximum curve magnitudes were significantly large in the progressed group, but no significantly different between maximum curve magnitudes in the stable group and initial curve magnitude in the progressed group. High curve apex locations were observed in the progressed group. Initial and maximum apex lateral deviations were clearly different in two groups and correlated with curve magnitudes from well to excellent (r = 0.43–0.98). The relationships between the spinal growth and the curve progressing were not consistent (r = −0.6 – +0.6). There were no evidences to show the significant differences of spinal growths between groups and genders.
Conclusions: Scoliosis progression is case dependent. Double curves dynamically progress between curve regions. Initial curve magnitudes have more significant effect on the progression than initial ages. A great progression can be expected from curves with high apex location. Apex lateral deviations are changing with curve magnitudes and spinal growths and, however, the curve magnitudes are not always increased with spinal growths. Funding: 2 Funding Parties: Alberta Provincial CIHR Training Program in Bone and Joint Health
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
