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Time series spinal radiographs as prognostic factors for scoliosis and progression of spinal deformities

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Abstract

The effectiveness of clinical measures to predict scoliotic progression is unclear. The objective of this study was to identify potential prognostic factors affecting scoliosis progression. Consecutive measurements (181) from 35 non-instrumented adolescent idiopathic scoliosis patients with at least two follow-up assessments were studied. Potential prognostic factors of gender, curve pattern, age, curve magnitude, apex location and lateral deviation and spinal growth were analyzed. Stable and progressed groups were compared (threshold: Cobb angle ≥5° or 10°) with sequential clinical data collected in 6-month intervals. Double curves progressed simultaneously or alternatively on curve regions. Age was not significantly different prior to and at maximal Cobb angle. Maximal Cobb angles were significantly correlated to initial Cobb angles (r = 0.81–0.98). Progressed males had larger initial Cobb angles than progressed females. Apex locations were higher in progressed than stable groups, and at least a half vertebra level higher in females than males. Maximal apex lateral deviations correlated significantly with the initial ones (r = 0.73–0.97) and moderately with maximal Cobb angles (r = 0.33–0.85). In the progressed groups, males had larger apex lateral deviations than females. Spinal growth did not relate to curve progression (r = −0.64 to +0.59) and was not significantly different between groups and genders. Scoliosis may dynamically progress between major and minor curves. Gender, curve magnitude, apex location and lateral deviation have stronger effects on scoliosis progression than age or spinal growth. Females with high apex locations may be expected to progress.

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Acknowledgments

The authors would like to recognize the contributions of the Canadian Institutes of Health Research (CIHR), the Alberta Children’s Hospital Foundation, the Fraternal Order of Eagles (Alberta & Saskatchewan), and the Natural Sciences and Engineering Research Council of Canada (NSERC).

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Authors and Affiliations

  1. Department of Mechanical and Manufacturing Engineering, Schulich School of Engineering, Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada

    Hongfa Wu, Janet L. Ronsky, Jessica C. Küpper & Ronald F. Zernicke

  2. Département de génie informatique, École Polytechnique de Montréal, CHU Sainte-Justine Centre de Recherche, 3175 Côte-Ste-Catherine, Montreal, QC, H3T 1C5, Canada

    Farida Cheriet

  3. Department of Orthopaedic Surgery, Alberta Children’s Hospital, 2888 Shaganappi Trail, Calgary, AB, T3B 6A8, Canada

    James Harder

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  1. Hongfa Wu
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  2. Janet L. Ronsky
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  3. Farida Cheriet
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  4. James Harder
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Correspondence to Janet L. Ronsky.

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Wu, H., Ronsky, J.L., Cheriet, F. et al. Time series spinal radiographs as prognostic factors for scoliosis and progression of spinal deformities. Eur Spine J 20, 112–117 (2011). https://doi.org/10.1007/s00586-010-1512-9

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  • DOI: https://doi.org/10.1007/s00586-010-1512-9

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