Abstract
Purpose
The progression of adolescent idiopathic scoliosis is closely correlated with longitudinal growth during puberty. A decreased incidence of curve progression has been found in male patients with adolescent idiopathic scoliosis compared with female patients with the condition. This finding implies that there might be a sexual dimorphism in the pubertal growth patterns of adolescent idiopathic scoliosis patients. Abnormal pubertal growth in female adolescent idiopathic scoliosis patients has been well characterized; however, the pubertal growth patterns of male adolescent idiopathic scoliosis patients have not been reported. We conducted a cross-sectional study of anthropometric measurements to compare the growth patterns of male patients with adolescent idiopathic scoliosis with those of healthy boys during puberty and explore the difference in the pubertal growth patterns of female and male patients with adolescent idiopathic scoliosis.
Methods
A total of 688 subjects were involved in the study, including 332 male adolescent idiopathic scoliosis patients and 356 age-matched healthy boys. The subjects were categorized according to their chronological ages. Their body weights, heights and arm spans were obtained using standard methods; the corrected body heights of the adolescent idiopathic scoliosis boys were determined using Bjour’s equation. The inter-group differences in the anthropometric parameters were analyzed. Multivariate regression analysis was carried out in the adolescent idiopathic scoliosis patients to identify the anthropometric parameters that influence curve severity.
Results
The corrected standing heights and arm spans of male adolescent idiopathic scoliosis patients were similar to those of the matched controls during puberty. However, the body weights of the adolescent idiopathic scoliosis patients who were more than 14 years old were significantly less than those of the control group. The body mass index of the adolescent idiopathic scoliosis patients between the ages of 15 and 17 were also significantly less than those of the control subjects. Moreover, a significantly higher incidence of underweight was found in adolescent idiopathic scoliosis patients (8.6%) than in the controls (3.4%). Upon multivariate regression analysis, body weight and chronological age were identified as independent predictors of curve magnitude in male adolescent idiopathic scoliosis patients. The male adolescent idiopathic scoliosis patients with variable curve patterns exhibited no significant differences in their anthropometric parameters.
Conclusions
The results showed abnormal pubertal growth in the male adolescent idiopathic scoliosis patients compared with their age- and gender-matched normal controls. Despite similar longitudinal growth, the male patients with adolescent idiopathic scoliosis exhibited significantly lower body weights and a higher incidence of underweight during the later stage of puberty compared with their normal controls. These abnormalities in the pubertal growth of male patients were different from those observed in female patients with adolescent idiopathic scoliosis. Body weight could be an important parameter for further longitudinal studies on the prognostication of curve progression in adolescent idiopathic scoliosis.
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References
Barrios C, Cortes S, Perez-Encinas C, Escriva MD, Benet I, Burgos J, Hevia E, Piza G, Domenech P (2011) Anthropometry and body composition profile of girls with non surgically-treated adolescent idiopathic scoliosis. Spine (Phila Pa 1976) (Epub ahead of print)
Biondi J, Weiner DS, Bethem D, Reed JF 3rd (1985) Correlation of Risser sign and bone age determination in adolescent idiopathic scoliosis. J Pediatr Orthop 5:697–701
Bjure J, Nachemson A (1973) Non-treated scoliosis. Clin Orthop Relat Res 93:44–52
Bunnell WP (1986) The natural history of idiopathic scoliosis before skeletal maturity. Spine (Phila Pa 1976) 11:773–776
Cheng JC, Leung SS, Chiu BS, Tse PW, Lee CW, Chan AK, Xia G, Leung AK, Xu YY (1998) Can we predict body height from segmental bone length measurements? A study of 3,647 children. J Pediatr Orthop 18:387–393
Cheng JC, Leung SS, Lau J (1996) Anthropometric measurements and body proportions among Chinese children. Clin Orthop Relat Res 323:22–30
Escalada F, Marco E, Duarte E, Muniesa JM, Belmonte R, Tejero M, Caceres E (2005) Growth and curve stabilization in girls with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 30:411–417
Goldberg CJ, Fogarty EE, Moore DP, Dowling FE (1997) Scoliosis and developmental theory: adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 22:2228–2237 discussion 2237–2228
Hagglund G, Karlberg J, Willner S (1992) Growth in girls with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 17:108–111
Karol LA (2001) Effectiveness of bracing in male patients with idiopathic scoliosis. Spine (Phila Pa 1976) 26:2001–2005
Karol LA, Johnston CE 2nd, Browne RH, Madison M (1993) Progression of the curve in boys who have idiopathic scoliosis. J Bone Joint Surg Am 75:1804–1810
Katz DE, Richards BS, Browne RH, Herring JA (1997) A comparison between the Boston brace and the Charleston bending brace in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 22:1302–1312
King HA, Moe JH, Bradford DS, Winter RB (1983) The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Jt Surg Am 65:1302–1313
Lee CF, Fong DY, Cheung KM, Cheng JC, Ng BK, Lam TP, Mak KH, Yip PS, Luk KD (2010) Referral criteria for school scoliosis screening: assessment and recommendations based on a large longitudinally followed cohort. Spine (Phila Pa 1976) 35:1492–1498
Lee WTK, Cheung CK, Tse YK, Guo X, Qin L, Ho SC, Lau J, Cheng JCY (2005) Generalized low bone mass of girls with adolescent idiopathic scoliosis is related to inadequate calcium intake and weight bearing physical activity in peripubertal period. Osteoporos Int 16:1024–1035
Little DG, Song KM, Katz D, Herring JA (2000) Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls. J Bone Jt Surg Am 82:685–693
Liu Z, Qiu Y, Qiu XS, Sun X (2009) Body mass index in Chinese girls with adolescent idiopathic scoliosis. In: EuroSpine, Spain, 2009
Lonstein JE, Carlson JM (1984) The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Jt Surg Am 66:1061–1071
Ma J, Wang Z, Song Y, Hu P, Zhang B (2010) BMI percentile curves for Chinese children aged 7–18 years, in comparison with the WHO and the US Centers for disease control and prevention references. Public Health Nutr 13(12):1990–1996
Modi HN, Modi CH, Suh SW, Yang JH, Hong JY (2009) Correlation and comparison of Risser sign versus bone age determination (TW3) between children with and without scoliosis in Korean population. J Orthop Surg Res 4:36
Normelli H, Sevastik J, Ljung G, Aaro S, Jonsson-Soderstrom AM (1985) Anthropometric data relating to normal and scoliotic Scandinavian girls. Spine (Phila Pa 1976) 10:123–126
Peterson LE, Nachemson AL (1995) Prediction of progression of the curve in girls who have adolescent idiopathic scoliosis of moderate severity. Logistic regression analysis based on data from the brace study of the scoliosis research society. J Bone Jt Surg Am 77:823–827
Qiu Y, Sun X, Qiu X, Li W, Zhu Z, Zhu F, Wang B, Yu Y, Qian B (2007) Decreased circulating leptin level and its association with body and bone mass in girls with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 32:2703–2710
Qiu Y, Zhu ZZ, Wang B, Yu Y, Qian BP, Zhu F (2008) Radiological presentations in relation to curve severity in scoliosis associated with syringomyelia. J Pediatr Orthop 28:128–133
Raggio CL (2006) Sexual dimorphism in adolescent idiopathic scoliosis. Orthop Clin North Am 37:555–558
Sadeghi H, Allard P, Barbier F, Gatto L, Chavet P, Rivard CH, Hinse S, Simoneau M (2008) Bracing has no effect on standing balance in females with adolescent idiopathic scoliosis. Med Sci Monit 14:293–298
Sanders JO, Browne RH, Cooney TE, Finegold DN, McConnell SJ, Margraf SA (2006) Correlates of the peak height velocity in girls with idiopathic scoliosis. Spine (Phila Pa 1976) 31:2289–2295
Sanders JO, Browne RH, McConnell SJ, Margraf SA, Cooney TE, Finegold DN (2007) Maturity assessment and curve progression in girls with idiopathic scoliosis. J Bone Jt Surg Am 89:64–73
Shuren N, Kasser JR, Emans JB, Rand F (1992) Reevaluation of the use of the Risser sign in idiopathic scoliosis. Spine (Phila Pa 1976) 17:359–361
Siu King Cheung C, Tak Keung Lee W, Kit Tse Y, Ping Tang S, Man Lee K, Guo X, Qin L, Chun Yiu Cheng J (2003) Abnormal peri-pubertal anthropometric measurements and growth pattern in adolescent idiopathic scoliosis: a study of 598 patients. Spine (Phila Pa 1976) 28:2152–2157
Smith FM, Latchford G, Hall RM, Millner PA, Dickson RA (2002) Indications of disordered eating behaviour in adolescent patients with idiopathic scoliosis. J Bone Jt Surg Br 84:392–394
Song KM, Little DG (2000) Peak height velocity as a maturity indicator for males with idiopathic scoliosis. J Pediatr Orthop 20:286–288
Soucacos PN, Zacharis K, Gelalis J, Soultanis K, Kalos N, Beris A, Xenakis T, Johnson EO (1998) Assessment of curve progression in idiopathic scoliosis. Eur Spine J 7:270–277
Suh PB, MacEwen GD (1988) Idiopathic scoliosis in males. A natural history study. Spine (Phila Pa 1976) 13:1091–1095
Wang WJ, Yeung HY, Chu WC, Tang NL, Lee KM, Qiu Y, Burwell RG, Cheng JC (2011) Top theories for the etiopathogenesis of adolescent idiopathic scoliosis. J Pediatr Orthop 31:S14–S27
Wang WW, Xia CW, Zhu F, Zhu ZZ, Wang B, Wang SF, Yeung BH, Lee SK, Cheng JC, Qiu Y (2009) Correlation of Risser sign, radiographs of hand and wrist with the histological grade of iliac crest apophysis in girls with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 34:1849–1854
Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA (2008) Adolescent idiopathic scoliosis. Lancet 371:1527–1537
Weinstein SL, Ponseti IV (1983) Curve progression in idiopathic scoliosis. J Bone Jt Surg Am 65:447–455
Weinstein SL, Zavala DC, Ponseti IV (1981) Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Jt Surg Am 63:702–712
Willner S (1974) Growth in height of children with scoliosis. Acta Orthop Scand 45:854–866
Wong HK, Hui JH, Rajan U, Chia HP (2005) Idiopathic scoliosis in Singapore schoolchildren: a prevalence study 15 years into the screening program. Spine (Phila Pa 1976) 30:1188–1196
Ylikoski M (2003) Height of girls with adolescent idiopathic scoliosis. Eur Spine J 12:288–291
Ylikoski M (2005) Growth and progression of adolescent idiopathic scoliosis in girls. J Pediatr Orthop B 14:320–324
Yrjonen T, Ylikoski M (2006) Effect of growth velocity on the progression of adolescent idiopathic scoliosis in boys. J Pediatr Orthop B 15:311–315
Yrjonen T, Ylikoski M, Schlenzka D, Poussa M (2007) Results of brace treatment of adolescent idiopathic scoliosis in boys compared with girls: a retrospective study of 102 patients treated with the Boston brace. Eur Spine J 16:393–397
Acknowledgments
This work was supported by Innovation Scholars Climbing Program in Jiangsu Province (BK2009001) and Fundamental Research Funds for the Central Universities (21414340026). The authors also would like to acknowledge the help from ZHU Feng, ZHU Ze-zhang, YU Yang, QIAN Bang-ping and WANG Bin in sample collection and manuscript revision.
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Wei-jun, W., Xu, S., Zhi-wei, W. et al. Abnormal anthropometric measurements and growth pattern in male adolescent idiopathic scoliosis. Eur Spine J 21, 77–83 (2012). https://doi.org/10.1007/s00586-011-1960-x
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DOI: https://doi.org/10.1007/s00586-011-1960-x