• Eur Spine J · Aug 2020

    Multicenter Study

    How do we follow-up patients with adolescent idiopathic scoliosis? Recommendations based on a multicenter study on the distal radius and ulna classification.

    • Yusuke Yamamoto, Hideki Shigematsu, CheungPrudence Wing HangPWHDepartment of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China., Akinori Okuda, Sachiko Kawasaki, Yasuhito Tanaka, and CheungJason Pui YinJPYDepartment of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China. cheungjp@hku.hk..
    • Department of Orthopaedic Surgery, Nara Medical University, Shijocho 840, Kashihara, Nara, 634-8521, Japan.
    • Eur Spine J. 2020 Aug 1; 29 (8): 2064-2074.

    PurposeTo determine the capability of the distal radius and ulna (DRU) classification for predicting the scoliosis progression risk within 1 year in patients with adolescent idiopathic scoliosis (AIS) and to develop simple recommendations for follow-up durations.MethodsMedical records of patients with AIS at two tertiary scoliosis referral centers were retrospectively reviewed for their DRU classification and major curve Cobb angles. Baseline DRU grades and Cobb angles with subsequent 1-year follow-up curve magnitudes were studied for scoliosis progression, which was defined as exacerbation of the Cobb angle by ≥ 6°. The relationship between DRU classification and scoliosis progression risk within 1 year was investigated. Patients were divided into three groups according to the Cobb angle (10°-19°, 20°-29°, ≥ 30°).ResultsOf the 205 patients with 283 follow-up visits, scoliosis progression occurred in 86 patients (90 follow-up visits). Radius and ulna grades were significantly related to scoliosis progression (p < 0.001). R6, R7, and U5 grades were significantly related to scoliosis progression risk. The curve progression probability increased as the Cobb angle increased. Cobb angles ≥ 30°, with these grades, led to progression in > 80% of patients within 1 year. Curve progression was less likely for grades R9 and U7. Most patients with more mature DRU grades did not experience progression, even with Cobb angles ≥ 30°.ConclusionWith R6, R7, and U5, scoliosis may progress within a short period; therefore, careful follow-up with short intervals within 6 months is necessary. R9 and U7 may allow longer 1-year follow-up intervals due to the lower progression risk.

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