The value of simplified skeletal maturity scoring system in the prediction of growth potential in female idiopathic scoliosis

English Keywords:Idiopathic scoliosis  Simplified skeletal maturity scoring system  Height velocity

English Abstract:

  【Abstract】 Objectives: To investigate the correlation between simplified skeletal maturity scoring system (SSMS) and other maturity indicators, and to evaluate its predictive value for growth potential in idiopathic scoliosis(IS) girls. Methods: Fifty female IS patients undergoing standardized bracing treatment were recruited in our study, including 32 major thoracic curves and 18 thoracolumbar curves. The average follow-up period was 3.1±0.9(2.0-5.6) years. SSMS, digital skeletal age(DSA) and radius, ulna, and small bones(RUS) scores were measured on posteroanterior radiographs of left hand at each visit, and the follow-up interval was 4-6 months. Moreover, the chronologic age, stage of menarche, standing height at each visit were recorded, and the height velocity(HV) was calculated at each follow-up. The Spearman coefficients were used to investigate the correlations of SSMS with DSA scores and RUS scores. Results: The average chronologic age, menarche age, SSMS stages, DSA scores and RUS scores at initial visit were 10.8±1.4(8.0-12.9) years, 12.5±2.2(10.1-14.8) years, 2.0±0.9(1-3), 370.1±55.7(240-487), 582.3±88.6(419-699), respectively. During the follow-up, the average peak height velocity(PHV) was 7.6±1.6(5.3-10.0)cm/years and the average age was 12.1±1.1 (10.5-13.8) years. 26%(13/50) of the IS patients in our study attained their PHV in SSMS 2, 52%(26/50) in SSMS 3, 16%(8/50) in SSMS 4, 4%(2/50) in SSMS 5, and 2%(1/50) in SSMS 6. Significant correlations of SSMS with DSA scores and RUS scores at each visit were found by the Spearman correlation analysis(r=0.958 and 0.967, P<0.001). Conclusions: The SSMS 2-4 suggests high growth potential and high height velocity in IS girls. Hence, SSMS can serve as a reliable predictor for growth potential in braced female IS patients.