The Journal of Bone and Joint Surgery, Vol 77, Issue 6 823-827, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
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
LE Peterson and AL Nachemson
Department of Orthopaedics, Goteborg University, Sweden.
In a study conducted by the Scoliosis Research Society, 159 girls with a
mean age of thirteen years (range, ten to fifteen years) who had adolescent
idiopathic scoliosis were followed prospectively until skeletal maturity or
until the curve had increased 6 degrees or more. All patients had had an
initial curve of 25 to 35 degrees and an apical level between the eighth
thoracic and first lumbar vertebrae, inclusive. Of the 159 patients, 120
were observed without treatment and thirty-nine were managed with lateral
electrical surface stimulation. The curve progressed at least 6 degrees in
eighty patients. There was no apparent difference in the outcome between
the patients who were managed with observation only and those who were
given electrical stimulation. Logistic regression analysis was performed to
determine which of eleven factors were predictive of progression of the
scoliotic curve. A Risser sign of 0 or 1, an apical level cephalad to the
twelfth thoracic vertebra, and an imbalance of ten millimeters or less were
found to be independently prognostic of progression of more than 6 degrees.
A prognostic model that included these three factors and chronological age
allowed correct classification of the curve as either progressive or
non-progressive in 81 per cent of these patients who had a thoracic or
thoracolumbar adolescent idiopathic scoliosis. The positive predictive
value was 82 per cent, the negative predictive value was 80 per cent, and
the sensitivity and specificity were each 81 per cent.
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