Evaluating the Feasibility of Cervical Vertebral Maturation Stages as an Alternative to Risser Sign in Assessing Skeletal Maturity in Adolescent Idiopathic Scoliosis Patients.

Background: Radiographic methods for evaluating skeletal maturity traditionally include the Risser sign and the hand-wrist maturation method. While the cervical vertebral maturation (CVM) stage is widely recognized in orthodontics, its application in assessing spinal growth, particularly in adolescent idiopathic scoliosis (AIS), has been less explored. This study explores the correlation between CVM, chronological age, and the Risser sign to evaluate the feasibility of CVM in assessing skeletal development in adolescents.

Methods: This prospective study included AIS patients and asymptomatic adolescents, aged 7-15 years, who underwent full-spine imaging with clear visibility of the cervical and pelvic regions. The correlation between CVM and the Risser sign was analyzed. The height of the cervical C3-7 vertebral body was measured, and its growth trend with age was examined. Differences between AIS patients and asymptomatic adolescents were compared.

Results: A total of 85 AIS patients (mean age 11.44 ± 2.36 years) and 47 asymptomatic adolescents (mean age 11.48 ± 3.14 years) were included. No statistically significant differences were observed in age, Risser sign grading, CVM staging, or C3-7 vertebral body height between the 2 groups. Chronological age showed a stronger correlation with CVM stages than with the Risser sign in both the AIS group (r = 0.93 vs. r = 0.82, P < 0.01) and the asymptomatic group (r = 0.81 vs. r = 0.72, P < 0.01).

Conclusions: The CVM stage, which shows a strong correlation with Risser sign grading, could serve as a reliable alternative for assessing skeletal maturity in adolescent subjects, particularly in clinical scenarios where minimizing radiation exposure is a priority.