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Extent of curve, other factors help characterize significant post-Sanders 7 progression of scoliosis

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LAS VEGAS — Continued curve progression can be expected in female pediatric patients with adolescent idiopathic scoliosis after they reach Sanders Stage 7 of maturity, according to results presented at the American Academy of Orthopaedic Surgeons Annual Meeting, here.

Olivia Grothaus , BA , and her colleagues retrospectively studied spinal curves in 89 patients with adolescent idiopathic scoliosis (AIS) once the patients reached Sanders Stage 7 (SS7), which is an indicator of early maturity in children. Investigators followed the patients for 2 years after that time point to analyze the characteristics of patients whose AIS curves progressed. The patients’ curves at SS7 were about 32°.

“Overall, half of our cohort demonstrated significant progression in the 2 years immediately following Sanders 7 and our rate was also much higher than what is reported for natural history. This alludes to the conclusion that the potential for progression remains after this point. We haven’t entered the phase of natural history yet,” Grothaus said.

The investigators focused on which patients progress at all or a minimum of 5° and found half of the patients had done so by SS7. In addition, in studying which patients met the criteria of a 50° curve or who progressed to surgery, which meant their AIS was clinically more significant, Grothaus said an analysis the researchers did showed a curve magnitude of about 40° was predictive of progressing to this criteria.

The third area of focus was patients who crossed the threshold of curves of 40°. “Those patients maybe be indicated for longer-term follow-up,” Grothaus said.

The results showed 70 patients had curves below 40 at SS7, 30% of whom progressed to more than 40° at follow-up, she said. – by Susan M. Rapp

Reference:

Grothaus O, et al. Abstract 212. Presented at: American Academy of Orthopaedic Surgeons; March 12-16, 2019; Las Vegas.

Disclosure: Grothaus reports no relevant financial disclosures.