根据曲线大小和骨骼成熟度改进对特发性脊柱侧弯进展的预测。

IF 1.6 Q3 CLINICAL NEUROLOGY
Spine deformity Pub Date : 2024-11-01 Epub Date: 2024-08-12 DOI:10.1007/s43390-024-00939-3
Kevin M Neal, Melanie Boeyer, Emily C Craver, Julia E Crook, Gary M Kiebzak
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引用次数: 0

摘要

目的:根据男孩和女孩目前的曲线幅度和桑德斯分期,利用大型患者队列和会诊,确定特发性脊柱侧弯(IS)曲线发展到35°、40°、45°和50°的风险,以提高精细度,并进行更准确的估计,从而指导治疗:方法:对前瞻性收集的脊柱侧凸数据库进行回顾性分析。方法:对前瞻性收集的脊柱侧弯数据库进行回顾性分析。广义估计方程逻辑回归模型根据起始曲线大小和桑德斯阶段估算出曲线发展到 35°、40°、45° 和 50°的概率。分别计算了男孩和女孩每个变量组合到每个终点的概率及其 95% 的置信区间:共纳入 309 名患者(80% 为女孩)。起始曲线大小和桑德斯分期对男女患者的病情进展均有显著的预测作用(P 均小于 0.04)。起始曲线尺寸越大、桑德斯分期越低,病情恶化的几率越大。结论:IS曲线遵循一种可预测的模式,当曲线越大、桑德斯分期越小时,曲线恶化的风险越大。根据这些因素,曲线恶化的风险是一个频谱,表明即使是桑德斯分期较高的许多较小曲线也存在一定的恶化风险。与之前的研究相比,该分析的颗粒度有所提高,这可能有助于向患者提供有关各种曲线大小终点的曲线进展风险的咨询,并有助于共同做出治疗决策:III级:回顾性队列研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving prediction of progression of idiopathic scoliosis based on curve size and skeletal maturity.

Purpose: To define the risk of curve progression of idiopathic scoliosis (IS) to 35°, 40°, 45°, and 50° based on current curve magnitude and Sanders stage for boys and girls, using a large cohort of patients and encounters, to improve granularity and allow more accurate estimations to guide treatment.

Methods: Retrospective analysis of a prospectively collected scoliosis database. Generalized estimation equation logistic regression models estimated probabilities of curve progression to 35°, 40°, 45°, and 50° based on starting curve size and Sanders stage. Probabilities and their 95% confidence intervals were calculated for each combination of variables to each endpoint separately for boys and girls.

Results: A total of 309 patients (80% girls) were included. Starting curve size and Sanders stage were significant predictors for progression in both sexes (all P ≤ 0.04). Higher starting curve sizes and lower Sanders stages were associated with greater odds of progression. Risk of progression was still present even at higher Sanders stages.

Conclusion: IS curves follow a predictable pattern, having more risk for progression when curves are larger and Sanders stages are smaller. Risk of curve progression is a spectrum based on these factors, indicating some risk of progression exists even for many smaller curves with higher Sanders stages. The improved granularity of this analysis compared to prior efforts may be useful for counseling patients about the risks of curve progression to various curve size endpoints and may aid shared decision-making regarding treatments.

Level of evidence or clinical relevance: Level III: retrospective cohort study.

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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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