Abstract
Idiopathic scoliosis is a growing spine disorder. Only a perfect knowledge of normal growth parameters such as bone age, stages of puberty, standing and sitting height, arm spam, Tanner stages, and weight allow the surgeon to plan the best treatment at the right moment. Measurements should be repeated and carefully recorded at regular intervals. Puberty is not a sudden event: it has a gradual onset and it is preceded by an incubation phase. It is not a point on a chart: it is a period that lasts two years beginning at a bone age of 11 and 13 years in girls and in boys, respectively. Two years of rapid growth (“acceleration phase”) are followed by three years of steady reduction of growth rates (“deceleration phase”). Skeletal maturation needs to be evaluated carefully to evaluate the progression risk of scoliosis during the phase of accelerating growth velocity. This article explains how to identify pubertal growth spurt, both clinically and radiographically, in order to correctly monitor patients with idiopathic scoliosis.
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References
Duval-Beaupère G, Lamireau T (1985) Scoliosis at less 30°. Properties of the evolutivity. Spine 5:421–424
Dimeglio A, Bonnel F, Canavese F (2011) Normal growth of the spine and thorax. In: Akbarnia BA et al (eds) The growing spine, 1st edn. Springer, Berlin, pp 13–42
Dimeglio A, Canavese F (2012) The growing spine: how spinal deformities influence normal spine and thoracic cage growth. Eur Spine J 21:64–70
Dimeglio A, Canavese F, Charles YP (2012) Adolescent idiopathic scoliosis: when and how much? J Pediatr Orthop 31(Suppl):S28–S36
Dimeglio A (1987) La croissance en orthopedie. Sauramps Medical, Montpellier
Dimeglio A (2005) Growth in pediatric orthopaedics. In: Morrissy T, Weinstein SL (eds) Lovell & Winter’s pediatric orthopaedics, 6th edn. Lippincott, William & Wilkins, Philadelphia, pp 35–61
Little DG, Song KM, Katz D, Herring A (2000) Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis. J Bone Joint Surg Am 82:685–693
Song KM, Little DG (2000) Peak height velocity as a maturity indicator for males with idiopathic scoliosis. J Pediatr Orthop 20:286–288
Dimeglio A (2001) Growth in pediatric orthopaedics. J Pediatr Orthop 21:549–555
Tanner JM, Whitehouse RH (1976) Clinical longitudinal standards for height, weight, height velocity and weight velocity and the stages of puberty. Arch Dis Child 51:170–179
Risser JC (1958) The iliac apophysis: an invaluable sign in the management of scoliosis. Clin Orthop 11:111–119
Dimeglio A, Charles YP, Daures JP, deRosa V, Kabore B (2005) Accuracy of the Sauvegrain method in determining skeletal age during Puberty. J Bone Joint Surg Am 87:1689–1696
Little DG, Sussman M (1994) The Risser sign: a critical analysis. J Pediatr Orthop 14:569–575
Lonstein JE, Carlson JM (1984) The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am 66:1061–1071
Shuren N, Kasser JR, Emans J, Rand F (1992) Revaluation of the use of the Risser sign in idiopathic scoliosis. Spine 17:359–361
Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. University Press, Stanford
Sempé M, Pavia C (1979) Atlas de la maturation squelettique. SIMEP, Paris
De Roo T, Schroder HJ (1977) Atlas van de skeletale leeftijd. Intercontinental Graphics, Dordrecht
Tanner JM, Whitehouse RH, Marshall WA, Healy MJR (1975) Assessment of skeletal maturity and prediction of adult height (TW2-Method). Academic Press, London
Acheson RM (1957) The Oxford method of assessing skeletal maturity. Clin Orthop 10:19–39
Pyle SI, Hoerr NL (1995) Radiographic atlas of skeletal development of the knee. Thomas, Springfield
Hoerr NL, Pyle SI, Francis CC (1962) Radiographic atlas of skeletal development of the foot and ankle. Thomas, Springfield
Sauvegrain J, Nahm H, Bronstein N (1962) Etude de la maturation osseuse du coude. Ann Radiol 5:542–550
Charles YP, Canavese F, Dimeglio A (2005) Skelettalterbestimmung am Ellbogen während des pubertären Wachstums. Orthopäde 34:1052–1060
Sanders JO, Khoury JG, Kishan S et al (2008) Predicting scoliosis progression from skeletal maturity: a simplified classification during adolescence. J Bone Joint Surg Am 90:540–553
Charles YP, Dimeglio A, Canavese F, Daures JP (2007) Skeletal age assessment from the olecranon for idiopathic scoliosis at Risser grade 0. J Bone Joint Surg Am 89:2737–2744
Duval-Beaupère G, Dubousset J, Queneau P (1970) Pour une theorie unique de l’evolution des scolioses. Presse Med 78:1141–1146
Dimeglio A, Bonnel F (1990) Le rachis en croissance. Springer, Paris
Charles YP, Daures JP, de Rosa V, Dimeglio A (2006) Progression risk of Idiopathic Juvenile scoliosis during pubertal growth. Spine 31:1933–1942
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Dimeglio, A., Canavese, F. Progression or not progression? How to deal with adolescent idiopathic scoliosis during puberty. J Child Orthop 7, 43–49 (2013). https://doi.org/10.1007/s11832-012-0463-6
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DOI: https://doi.org/10.1007/s11832-012-0463-6