S Pesenti1, J-L Jouve2, C Morin3, S Wolff4, J Sales de Gauzy5, A Chalopin6, A Ibnoulkhatib5, E Polirsztok7, A Walter7, S Schuller7, K Abelin-Genevois8, J Leroux9, J Lechevallier9, R Kabaj10, P Mary10, S Fuentes11, H Parent12, C Garin8, K Bin2, E Peltier2, B Blondel2, D Chopin13. 1. Service d'orthopédie pédiatrique, hôpital d'Enfants de la Timone, Aix-Marseille université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France. Electronic address: sebastien.pesenti@ap-hm.fr. 2. Service d'orthopédie pédiatrique, hôpital d'Enfants de la Timone, Aix-Marseille université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France. 3. Service d'orthopédie pédiatrique, institut Calot, rue du Docteur-Calot, 62600 Berck-sur-Mer, France. 4. Service d'orthopédie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France. 5. Service d'orthopédie pédiatrique, hôpital des Enfants, 330, avenue de Grande-Bretagne, 31029 Toulouse cedex, France. 6. Service d'orthopédie pédiatrique, hôpital d'Enfants, 7, quai Moncousu, 44000 Nantes, France. 7. Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France. 8. Service d'orthopédie pédiatrique, hôpital Femme-Mère-Enfants, CHU de Lyon, 59, boulevard Pinel, 69677 Bron, France. 9. Clinique chirurgicale infantile, centre hospitalier universitaire de Rouen, 1, rue de Germont, 76000 Rouen, France. 10. Service d'orthopédie pédiatrique, hôpital Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France. 11. Service de neurochirurgie, Timone, 264, rue Saint-Pierre, 13385 Marseille, France. 12. Centre du rachis, clinique Saint-Léonard, 18, rue de Bellinière, 49800 Trélazé, France. 13. Service de chirurgie rachidienne, hôpital Roger-Salengro, rue Émile-Laine, 59037 Lille, France.
Abstract
INTRODUCTION: To date there is no consensus on therapeutic indications in adolescent idiopathic scoliosis (AIS) with curvature between 30° and 60° at the end of growth. OBJECTIVE: The objective of this study was to assess outcome in patients with moderate AIS. MATERIAL AND METHODS: A multicenter retrospective study was conducted. Inclusion criteria were: Cobb angle, 30-60° at end of growth; and follow-up > 20 years. The data collected were angular values in adolescence and at last follow-up, and quality of life scores at follow-up. RESULTS: A total of 258 patients were enrolled: 100 operated on in adolescence, 116 never operated on, and 42 operated on in adulthood. Mean follow-up was 27.8 years. Cobb angle progression significantly differed between the 3 groups: 3.2° versus 8.8° versus 23.6°, respectively; P < 0.001. In lumbar scoliosis, the risk of progression to ≥ 20° was significantly higher for initial Cobb angle > 35° (OR=4.278, P=0.002). There were no significant differences in quality of life scores. DISCUSSION: Patients operated on in adolescence showed little radiological progression, demonstrating the efficacy of surgical treatment for curvature greater than 50°. Curvature greater than 40° was progressive and may require surgery in adulthood. Lumbar scoliosis showed greater potential progression than thoracic scoliosis in adulthood, requiring fusion as of 35° angulation. LEVEL OF EVIDENCE: IV, retrospective study.
INTRODUCTION: To date there is no consensus on therapeutic indications in adolescent idiopathic scoliosis (AIS) with curvature between 30° and 60° at the end of growth. OBJECTIVE: The objective of this study was to assess outcome in patients with moderate AIS. MATERIAL AND METHODS: A multicenter retrospective study was conducted. Inclusion criteria were: Cobb angle, 30-60° at end of growth; and follow-up > 20 years. The data collected were angular values in adolescence and at last follow-up, and quality of life scores at follow-up. RESULTS: A total of 258 patients were enrolled: 100 operated on in adolescence, 116 never operated on, and 42 operated on in adulthood. Mean follow-up was 27.8 years. Cobb angle progression significantly differed between the 3 groups: 3.2° versus 8.8° versus 23.6°, respectively; P < 0.001. In lumbar scoliosis, the risk of progression to ≥ 20° was significantly higher for initial Cobb angle > 35° (OR=4.278, P=0.002). There were no significant differences in quality of life scores. DISCUSSION: Patients operated on in adolescence showed little radiological progression, demonstrating the efficacy of surgical treatment for curvature greater than 50°. Curvature greater than 40° was progressive and may require surgery in adulthood. Lumbar scoliosis showed greater potential progression than thoracic scoliosis in adulthood, requiring fusion as of 35° angulation. LEVEL OF EVIDENCE: IV, retrospective study.
Authors: B Ilharreborde; E Ferrero; A Angelliaume; Y Lefèvre; F Accadbled; A L Simon; J Sales de Gauzy; K Mazda Journal: Eur Spine J Date: 2017-04-07 Impact factor: 3.134
Authors: Sebastien Pesenti; Jean-Luc Clément; Brice Ilharreborde; Christian Morin; Yann Philippe Charles; Henri François Parent; Philippe Violas; Marc Szadkowski; Louis Boissière; Jean-Luc Jouve; Federico Solla Journal: Eur Spine J Date: 2022-02-28 Impact factor: 3.134