Curve progression and spinal growth in brace treated idiopathic scoliosis

The risk of progression of idiopathic scoliosis is correlated primarily to factors that predict potential remaining skeletal growth. The aim of the cu rrent study was to evaluate spinal growth, measured as the length of the sc oliotic spine on serial longitudinal radiographs, and its relationship to p rogression of the scoliotic curve. The retrospective study was based on mea surements made on standing anteroposterior radiographs of 60 patients with adolescent idiopathic scoliosis. In all patients, a Boston brace was prescr ibed during the followup period. Despite brace treatment, a significantly g reater average progression rate of the scoliotic curve was seen in periods of rapid to moderate growth (greater than or equal to 10 mm per year) compa red with periods of small or no growth (<10 mm per year). The difference in progression rates concerned the increase of the Cobb angle and the increas e of lateral deviation and axial rotation. These findings indicate the leng th of the spine measured on subsequent radiographs is an excellent paramete r to determine spinal growth and thus an excellent predictor of scoliosis p rogression, With the presented growth charts, which were derived from the m easured individual growth velocity values of the patients in the study, it is possible to predict future spinal growth at different chronologic ages.