Yim, Annie P. Y. MPhil; YEUNG, Hiu-Yan PhD; HUNG, Vivian W. Y. MPhil; LEE, Kwong-Man PhD; LAM, Tsz-Ping FRCS; NG, Bobby K. W. FRCS; QIU, Yong MD; CHENG, Jack C. Y. MD
Abstract
Study Design. A cross-sectional and prospective longitudinal study on the anthropometric parameters and growth pattern of adolescent idiopathic scoliosis (AIS) girls.
Objective. To investigate the growth pattern of AIS girls with different severities using cross-sectional and prospective longitudinal data set in comparison with age-matched healthy controls.
Summary of Background Data. AIS occurs in children during their pubertal growth spurt. Although there is no clear consensus on the difference in body height between AIS girls and healthy controls, it is generally believed that the development and curve progression in AIS girls is closely associated with their growth rate. There is no concrete prospective longitudinal study to document clearly the growth pattern and growth rate of AIS subjects.
Methods. 611 AIS girls and 296 healthy age-matched controls were included in the study and among them, 194 AIS girls and 116 healthy controls were followed up until skeletal maturity. The AIS girls were grouped into moderate (AIS20) and severe curve (AIS40) groups based on maximum curve magnitude at skeletal maturity. Clinical data and detailed anthropometric parameters were recorded. In the cross-sectional analysis, the groups of subjects were compared within different age groups (from age 12 to 16). In the longitudinal study, linear mixed modeling with respect to age or years since menarche was employed to formulate the growth trajectory of different anthropometric parameters.
Results. In the cross-sectional analysis, the AIS girls were generally taller, with longer arm span, and lower BMI than the healthy controls. The AIS40 girls were found to be significantly shorter in height (p = 0.006) and arm span (p = 0.025) at age 12 but caught up and overtook the control group at age 14 to 16. In the longitudinal study, the average growth rate of arm span in AIS40 girls were significantly higher than AIS20 girls (>30%) (p = 0.004) and controls (>70%) (p = 0.0004). The age of menarche of AIS40 girls was significantly delayed by 5.9 months and 3.8 months when compared with the control group and AIS20 girls respectively (p<0.05).
Conclusion. The growth patterns of AIS girls with confirmed curve severities were significantly different from healthy age-matched controls. Severe AIS girls had delayed menarche with faster skeletal growth rate during age 12-16. Monitoring the rate of change of arm span of AIS girls could be an important additional clinical parameter in helping to predict curve severity in AIS girls.
http://journals.lww.com/spinejournal/Abstract/publishahead/Abnormal_Skeletal_Growth_Patterns_in_Adolescent.98282.aspx
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