{"title":"中度青少年特发性脊柱侧凸的自然病程:一项平均25年随访研究。","authors":"Masayuki Ohashi, Kei Watanabe, Toru Hirano, Kazuhiro Hasegawa, Hideki Tashi, Keitaro Minato, Yohei Shibuya, Masayuki Sato, Mio Kubota, Hiroyuki Sekimoto, Hiroyuki Kawashima","doi":"10.1007/s00586-025-09135-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the natural course of moderate adolescent idiopathic scoliosis (AIS) in terms of curve progression and health-related quality of life (HRQOL).</p><p><strong>Methods: </strong>The inclusion criteria were nonoperatively treated patients with AIS who had a major curve between 30° and 40° at skeletal maturity (Risser ≥ 4) and age ≥ 30 years at the survey. Fifty-eight patients (55 women) were included (follow-up rate, 37.4%). The mean age was 14.2 years at skeletal maturity and 39.9 years at the survey, with a mean 25.7-year follow-up. The HRQOL scores were compared with age- and sex-matched healthy volunteers (n = 112).</p><p><strong>Results: </strong>The median magnitude of the major curve was 36.5° at skeletal maturity (n = 58), 40° at the age of 18 years (n = 30), and 45.5° at the survey (n = 47) with a progression rate of 0.5°/year. The major curve at the survey was over 50° in 46.7% of patients, 82.4% of whom had already had major curves ≥ 40° at the age of 18 years. Despite their curve progression, patients demonstrated comparable HRQOL scores with control participants, except for the SRS-22 self-image score (AIS 2.8 vs. Control 3.4, p < 0.001).</p><p><strong>Conclusion: </strong>Moderate AIS progressed slowly but significantly throughout adulthood. Over 40% of the curves were > 50° during the mean 25-year follow-up period. Although the HRQOL scores of adult patients with moderate AIS at skeletal maturity were comparable with those of the controls, their cosmetic concerns could not be disregarded. Therefore, moderate curves, especially those ≥ 40° at the age approximately 18 years, warrant long-term follow-up.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Natural course of moderate adolescent idiopathic scoliosis: a mean 25-year follow-up study.\",\"authors\":\"Masayuki Ohashi, Kei Watanabe, Toru Hirano, Kazuhiro Hasegawa, Hideki Tashi, Keitaro Minato, Yohei Shibuya, Masayuki Sato, Mio Kubota, Hiroyuki Sekimoto, Hiroyuki Kawashima\",\"doi\":\"10.1007/s00586-025-09135-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study aimed to determine the natural course of moderate adolescent idiopathic scoliosis (AIS) in terms of curve progression and health-related quality of life (HRQOL).</p><p><strong>Methods: </strong>The inclusion criteria were nonoperatively treated patients with AIS who had a major curve between 30° and 40° at skeletal maturity (Risser ≥ 4) and age ≥ 30 years at the survey. Fifty-eight patients (55 women) were included (follow-up rate, 37.4%). The mean age was 14.2 years at skeletal maturity and 39.9 years at the survey, with a mean 25.7-year follow-up. The HRQOL scores were compared with age- and sex-matched healthy volunteers (n = 112).</p><p><strong>Results: </strong>The median magnitude of the major curve was 36.5° at skeletal maturity (n = 58), 40° at the age of 18 years (n = 30), and 45.5° at the survey (n = 47) with a progression rate of 0.5°/year. The major curve at the survey was over 50° in 46.7% of patients, 82.4% of whom had already had major curves ≥ 40° at the age of 18 years. Despite their curve progression, patients demonstrated comparable HRQOL scores with control participants, except for the SRS-22 self-image score (AIS 2.8 vs. Control 3.4, p < 0.001).</p><p><strong>Conclusion: </strong>Moderate AIS progressed slowly but significantly throughout adulthood. Over 40% of the curves were > 50° during the mean 25-year follow-up period. Although the HRQOL scores of adult patients with moderate AIS at skeletal maturity were comparable with those of the controls, their cosmetic concerns could not be disregarded. Therefore, moderate curves, especially those ≥ 40° at the age approximately 18 years, warrant long-term follow-up.</p>\",\"PeriodicalId\":12323,\"journal\":{\"name\":\"European Spine Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-07-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00586-025-09135-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00586-025-09135-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Natural course of moderate adolescent idiopathic scoliosis: a mean 25-year follow-up study.
Purpose: This study aimed to determine the natural course of moderate adolescent idiopathic scoliosis (AIS) in terms of curve progression and health-related quality of life (HRQOL).
Methods: The inclusion criteria were nonoperatively treated patients with AIS who had a major curve between 30° and 40° at skeletal maturity (Risser ≥ 4) and age ≥ 30 years at the survey. Fifty-eight patients (55 women) were included (follow-up rate, 37.4%). The mean age was 14.2 years at skeletal maturity and 39.9 years at the survey, with a mean 25.7-year follow-up. The HRQOL scores were compared with age- and sex-matched healthy volunteers (n = 112).
Results: The median magnitude of the major curve was 36.5° at skeletal maturity (n = 58), 40° at the age of 18 years (n = 30), and 45.5° at the survey (n = 47) with a progression rate of 0.5°/year. The major curve at the survey was over 50° in 46.7% of patients, 82.4% of whom had already had major curves ≥ 40° at the age of 18 years. Despite their curve progression, patients demonstrated comparable HRQOL scores with control participants, except for the SRS-22 self-image score (AIS 2.8 vs. Control 3.4, p < 0.001).
Conclusion: Moderate AIS progressed slowly but significantly throughout adulthood. Over 40% of the curves were > 50° during the mean 25-year follow-up period. Although the HRQOL scores of adult patients with moderate AIS at skeletal maturity were comparable with those of the controls, their cosmetic concerns could not be disregarded. Therefore, moderate curves, especially those ≥ 40° at the age approximately 18 years, warrant long-term follow-up.
期刊介绍:
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe