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

Article dans une revue avec comité de lecture
Author
ccVERGARI, Claudio
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
ccSKALLI, Wafa
ABELIN-GENEVOIS, Kariman
90015 Department of Orthopaedic Surgery
353860 Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
BERNARD, Jean Claude
90015 Department of Orthopaedic Surgery
353860 Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
HU, Zongshan
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
CHENG, Jack Chun Yiu
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
CHU, Winnie Chiu Wing
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
ASSI, Ayman
301405 Université Saint-Joseph de Beyrouth [USJ]
KARAM, Mohammad
301405 Université Saint-Joseph de Beyrouth [USJ]
GHANEM, Ismat
301405 Université Saint-Joseph de Beyrouth [USJ]
BASSANI, Tito
1004551 IRCCS Istituto Ortopedico Galeazzi
GALBUSERA, Fabio
1004551 IRCCS Istituto Ortopedico Galeazzi
SCONFIENZA, Luca Maria
300694 Università degli Studi di Milano = University of Milan [UNIMI]
1004551 IRCCS Istituto Ortopedico Galeazzi
BRAYDA-BRUNO, Marco
1004551 IRCCS Istituto Ortopedico Galeazzi
COURTOIS, Isabelle
51335 Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
EBERMEYER, Eric
51335 Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
VIALLE, Raphael
LANGLAIS, Tristan
DUBOUSSET, Jean

URI
http://hdl.handle.net/10985/20226
DOI
10.1007/s00330-021-07944-4
Date
2021
Journal
European Radiology

Abstract

Objectives 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. Methods 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. Results 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%). Conclusions 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.

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