Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls
Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls
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DOI：
10.2106/00004623-200005000-00009
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发表时间：
2000-05-01
影响因子：
5.3
通讯作者：
Herring, JA
中科院分区：
文献类型：
--
作者：
Little, DG;Song, KM;Herring, JA
背景：我们的目的是比较特发性脊柱侧凸女孩和未患脊柱侧凸的青少年的身高速度数据。我们还比较了生长数据与按时间顺序的年龄、月经初潮年龄和Risser征在预测脊柱侧弯生长和进展方面的准确性。方法：在特发性脊柱侧凸患者数据库中，371名使用支具治疗的女孩中有120的人有足够的身高数据来量化他们的生长峰值。身高速度数据是通过在脊柱侧弯诊所获得的站立高度测量产生的，测量之间的最小间隔为6个月，并计算了高度速度峰值的时间。从患者的记录中记录月经初潮年龄。Kisser征和Cobb角由一个观察者确定。脊柱侧弯的进展被定义为在至少六个月后，与最初评估时的曲度相比，Cobb角增加至少10度。进展到需要手术的程度定义为进展至少10度到45度或更高。结果：按峰值速度分组的高度速度图显示出峰值和急剧下降，数值与正常人群相似。从百分位数图表推断，90%的患者在身高峰值速度达到3.6年后停止生长。当使用年龄、月经初潮年龄和Kisser征来预测生长时，生长高峰变得迟钝(在太长的时间内平均，以至于最快增长时期的数据与较慢增长时期的数据平均)；这表明这些成熟度标准在生长方面对患者进行了较差的分组。120名患者中有88名患者的初级曲线是递进的。在这些患者中，有60人在峰值速度时曲度超过30度，其中50人(83%)的曲度进展到45度或更高。其余28例患者的峰值速度曲线在30度或更小，只有一条曲线(4%)进展到45度或以上。峰值速度也比其他成熟度标准更准确地将曲线最大进展分组，因为大多数曲线在峰值速度时进展最大。年龄、月经初潮年龄和Risser征预测脊柱侧凸最大进展的时间分布范围更广。结论特发性脊柱侧弯患者的临床身高测量所产生的身高速度记录了生长高峰并可靠地预测了生长停止。了解生长高峰期的时间可以提供有价值的信息，了解进展到需要脊柱关节融合术的程度的可能性。
Background Our aim was to compare height velocity data, obtained from clinical height measurements, for girls who had idiopathic scoliosis with the data for adolescents who did not have scoliosis. We also compared the growth data with chronological age, menarchal age, and Risser sign in terms of their accuracy in the prediction of growth and progression of the scoliosis.Methods: One hundred and twenty of 371 patients in a database of girls managed with a brace for the treatment of idiopathic scoliosis had sufficient height data for us to quantify their growth peak. Height velocity data was generated from standing-height measurements obtained, in a scoliosis clinic, with a minimum six-month interval between measurements, and the timing of peak height velocity was calculated. The age at menarche was recorded from the patients' records. The Kisser sign and Cobb angle were determined by a single observer. Progression of the scoliosis was defined as an increase in the Cobb angle of at least 10 degrees, compared with the curve magnitude at the time of the initial evaluation, after a minimum of six months. Progression to a magnitude requiring surgery was defined as progression of at least 10 degrees to a magnitude of 45 degrees or more.Results: The height velocity plot grouped by peak height velocity showed a high peak and a sharp decline with values similar to those in normal populations. Extrapolating from percentile charts, 90 percent of our patients ceased growing by 3.6 years after peak height velocity. The growth peak was blunted (averaged over too long a period such that the data for the period of most rapid growth was averaged in with that for a period of slower growth) when chronological age, menarchal age, and Kisser sign were used to predict growth; this indicated that these maturity scales grouped the patients poorly in terms of growth.The primary curve was progressive in eighty-eight of the 120 patients. Sixty of these patients had a curve of more than 30 degrees at peak height velocity, and in fifty (83 percent) of the sixty the curve progressed to 45 degrees or more. The remaining twenty-eight patients had a curve of 30 degrees or less at peak height velocity, with only one curve (4 percent) progressing to 45 degrees or more.Peak height velocity also grouped patients for maximal progression of the curve more accurately than did the other maturity scales, as most of the curves progressed maximally at peak height velocity. There was a wider spread of timing of maximal progression when chronological age, menarchal age, and Risser sign were used to predict progression.Conclusions Height velocities generated from clinical height measurements for patients with idiopathic scoliosis document the growth peak and predict cessation of growth reliably. Knowing the timing of the growth peak provides valuable information on the likelihood of progression to a magnitude requiring spinal arthrodesis.