Distal radius and ulna classification system as a good predictor for growth potential and curve progression in idiopathic scoliosis

English Keywords:Idiopathic scoliosis  Radius  Ulna  Maturity assessment  Curve progression

English Abstract:

  【Abstracts】 Objectives: To correlate the distal radius and ulna stages(DRU) with several growth potential indicators, and to evaluate the predictive value of DRU system for curve progression in a group of braced idiopathic scoliosis(IS) patients. Methods: This was a consecutive longitudinal study on physically immature IS girls, who had received standardized bracing treatment and regular follow-up every 3-6 months until brace weaning. The following data of each follow-up were collected: chronologic age, height, Cobb angle, spinal length, Risser sign, digital skeletal age(DSA) scores and DRU scores. The height velocity(HV), angle velocity(AV) and spinal length velocity(SLV) of each follow-up were calculated. The values of HV, SLV and AV were analyzed and the rates of AV>5°/y were compared among different DRU stages. Results: Thirty-six braced IS girls with single thoracic or thoracolumbar curves were reviewed. The average age at the first visit was 10.8±1.2 years. The average values of initial DRU scores were R6.3±1.2 and U4.6±1.5 for radius and ulna, respectively. Both R7-R9 and U5-U7 indicated high HV, high SLV and high AV. The rates of AV> 5°/y were significantly higher in patients within R7-R9 and U5-U7(P<0.05). Moreover, the scores of distal radius and distal ulna were significantly correlated(P<0.001). Conclusions: The distal radius stages R7-R9 and distal ulna stages U5-U7 indicate the high height velocity, high spinal growth velocity and high angle velocity. The DRU scoring system can serve as a good indicator for the growth potential and curve progression in braced IS patients.