Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up
Background and purpose: Treatment of idiopathic scoliosis in childhood aims to prevent curve progression. It is generally accepted that curves > 50° have the highest risk of progression, but less well described is what happens with mild to moderate curves. The aim of this study was to assess lon...
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Medical Journals Sweden
2025-01-01
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| Series: | Acta Orthopaedica |
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| Online Access: | https://actaorthop.org/actao/article/view/42659 |
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| author | Casper Dragsted Lærke Ragborg Søren Ohrt-Nisse Thomas Andersen Martin Gehrchen Benny Dahl |
| author_facet | Casper Dragsted Lærke Ragborg Søren Ohrt-Nisse Thomas Andersen Martin Gehrchen Benny Dahl |
| author_sort | Casper Dragsted |
| collection | DOAJ |
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Background and purpose: Treatment of idiopathic scoliosis in childhood aims to prevent curve progression. It is generally accepted that curves > 50° have the highest risk of progression, but less well described is what happens with mild to moderate curves. The aim of this study was to assess long-term curve progression and health-related quality of life (HRQoL) and compare thoracic and thoracolumbar/lumbar (TL/L) curves.
Methods: We identified 177 patients diagnosed with a pediatric spinal deformity and treated at our institution from 1972 through 1983. 91 of 129 eligible patients with idiopathic scoliosis completed follow-up (71%). Patient files from treatment/observation in childhood were reviewed including detailed descriptions of radiographs. At follow-up we assessed long standing full-spine radiographs and HRQoL with the Scoliosis Research Society 22 revised questionnaire.
Results: Mean follow-up was 41 years (standard deviation [SD] 2.5 years). 21 patients underwent surgery in adolescence or early adulthood leaving 70 patients for analysis of curve progression, of whom 61 had complete radiographs. For patients with a main curve < 25° at the end of treatment in adolescence (n = 19) mean curve progression was 7° (SD 9); for 25–40° curves (n = 26) 16° (SD 13); for 40–50° curves (n =10) 22° (SD 8); and for curves > 50° (n = 6) 17° (SD 6). There was a linear association between main curve size at follow-up and SRS-22r subtotal score (P = 0.003).
Conclusion: We found substantial curve progression for patients with main curves > 25° at end of treatment, but with a considerable variation between patients. Curve progression was not associated with curve size at the end of treatment and did not differ significantly between thoracic and TL/L curves. Larger main curve size at follow-up was associated with lower HRQoL.
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| format | Article |
| id | doaj-art-5a25f26c547044f092f3b8641717be4d |
| institution | Kabale University |
| issn | 1745-3674 1745-3682 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj-art-5a25f26c547044f092f3b8641717be4d2025-01-20T18:36:19ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822025-01-019610.2340/17453674.2024.42659Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-upCasper Dragsted0https://orcid.org/0000-0003-3077-8959Lærke Ragborg1Søren Ohrt-Nisse2https://orcid.org/0000-0002-8234-9948Thomas Andersen3Martin Gehrchen4Benny Dahl5Spine Unit, Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen, DenmarkSpine Unit, Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen, DenmarkSpine Unit, Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen, DenmarkSpine Unit, Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen, DenmarkSpine Unit, Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen, DenmarkSpine Unit, Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen, Denmark Background and purpose: Treatment of idiopathic scoliosis in childhood aims to prevent curve progression. It is generally accepted that curves > 50° have the highest risk of progression, but less well described is what happens with mild to moderate curves. The aim of this study was to assess long-term curve progression and health-related quality of life (HRQoL) and compare thoracic and thoracolumbar/lumbar (TL/L) curves. Methods: We identified 177 patients diagnosed with a pediatric spinal deformity and treated at our institution from 1972 through 1983. 91 of 129 eligible patients with idiopathic scoliosis completed follow-up (71%). Patient files from treatment/observation in childhood were reviewed including detailed descriptions of radiographs. At follow-up we assessed long standing full-spine radiographs and HRQoL with the Scoliosis Research Society 22 revised questionnaire. Results: Mean follow-up was 41 years (standard deviation [SD] 2.5 years). 21 patients underwent surgery in adolescence or early adulthood leaving 70 patients for analysis of curve progression, of whom 61 had complete radiographs. For patients with a main curve < 25° at the end of treatment in adolescence (n = 19) mean curve progression was 7° (SD 9); for 25–40° curves (n = 26) 16° (SD 13); for 40–50° curves (n =10) 22° (SD 8); and for curves > 50° (n = 6) 17° (SD 6). There was a linear association between main curve size at follow-up and SRS-22r subtotal score (P = 0.003). Conclusion: We found substantial curve progression for patients with main curves > 25° at end of treatment, but with a considerable variation between patients. Curve progression was not associated with curve size at the end of treatment and did not differ significantly between thoracic and TL/L curves. Larger main curve size at follow-up was associated with lower HRQoL. https://actaorthop.org/actao/article/view/42659Curve progressionIdiopathic scoliosisPaediatric orthopaedicsRadiological imagingSpine |
| spellingShingle | Casper Dragsted Lærke Ragborg Søren Ohrt-Nisse Thomas Andersen Martin Gehrchen Benny Dahl Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up Acta Orthopaedica Curve progression Idiopathic scoliosis Paediatric orthopaedics Radiological imaging Spine |
| title | Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up |
| title_full | Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up |
| title_fullStr | Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up |
| title_full_unstemmed | Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up |
| title_short | Curve progression in non-surgically treated patients with idiopathic scoliosis: a cohort study with 40-year follow-up |
| title_sort | curve progression in non surgically treated patients with idiopathic scoliosis a cohort study with 40 year follow up |
| topic | Curve progression Idiopathic scoliosis Paediatric orthopaedics Radiological imaging Spine |
| url | https://actaorthop.org/actao/article/view/42659 |
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