Effect of curve location on the severity index for adolescent idiopathic scoliosis: a longitudinal cohort study

Autor: Jean-Claude Bernard, Raphaël Vialle, Ayman Assi, Jean Dubousset, Fabio Galbusera, Wafa Skalli, Mohammad Karam, Claudio Vergari, Isabelle Courtois, Marco Brayda-Bruno, Tristan Langlais, Kariman Abelin-Genevois, Tito Bassani, Ismat Ghanem, Eric Ebermeyer, Zongshan Hu, Luca Maria Sconfienza, Winnie C.W. Chu, Jack C. Y. Cheng
Přispěvatelé: Institut de Biomécanique Humaine Georges Charpak (IBHGC), Université Sorbonne Paris Nord-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM), Department of Orthopaedic Surgery, Université Catholique de Louvain = Catholic University of Louvain (UCL), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), The Chinese University of Hong Kong [Hong Kong], Université Saint-Joseph de Beyrouth (USJ), IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano [Milano] (UNIMI), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Service de pédiatrie orthopédique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)
Rok vydání: 2021
Předmět:
Zdroj: European Radiology
European Radiology, 2021, ⟨10.1007/s00330-021-07944-4⟩
ISSN: 1432-1084
0938-7994
Popis: Adolescent idiopathic scoliosis (AIS) is the most common spinal disorder in children. A severity index was recently proposed to identify the stable from the progressive scoliosis at the first standardized biplanar radiographic exam. The aim of this work was to extend the validation of the severity index and to determine if curve location influences its predictive capabilities. AIS patients with Cobb angle between 10° and 25°, Risser 0–2, and no previous treatment were included. They underwent standing biplanar radiography and 3D reconstruction of the spine and pelvis, which allowed to calculate their severity index. Patients were grouped by curve location (thoracic, thoracolumbar, lumbar). Patients were followed up until skeletal maturity (Risser ≥ 3) or brace prescription. Their outcome was compared to the prediction made by the severity index. In total, 205 AIS patients were included; 82% of them (155/189, 95% confidence interval [74–90%]) were correctly classified by the index, while 16 patients were unclassified. Positive predictive ratio was 78% and negative predictive ratio was 86%. Specificity (78%) was not significantly affected by curve location, while patients with thoracic and lumbar curves showed higher sensitivity (≥ 89%) than those with thoracolumbar curves (74%). In this multicentric cohort of 205 patients, the severity index was used to predict the risk of progression from mild to moderate scoliosis, with similar results of typical major curve types. This index represents a novel tool to aid the clinician and the patient in the modulation of the follow-up and, for progressive patients, their decision for brace treatment. • The severity index of adolescent idiopathic scoliosis has the potential to detect patients with progressive scoliosis as early as the first exam. • Out of 205 patients, 82% were correctly classified as either stable or progressive by the severity index. • The location of the main curve had small effect on the predictive capability of the index.
Databáze: OpenAIRE
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