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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3895

Title: How do we follow-up patients with adolescent idiopathic scoliosis? Recommendations based on a multicenter study on the distal radius and ulna classification.
Other Titles: DRU classificationに基づく特発性側弯症の適切な観察間隔の設定 多施設研究
Authors: Yamamoto, Yusuke
Shigematsu, Hideki
Cheung, Prudence Wing Hang
Okuda, Akinori
Kawasaki, Sachiko
Tanaka, Yasuhito
Cheung, Jason Pui Yin
Keywords: Adolescent idiopathic scoliosis
Distal radius and ulna classification
Bone age
Cobb angle
Curve progression
Follow-up duration
Issue Date: Aug-2020
Publisher: Springer Nature
Citation: European spine journal Vol.29 No.8 p.2064-2074 (2020 Aug)
Abstract: Purpose: To determine the capability of the distal radius and ulna (DRU) classification for predicting the scoliosis progression risk within 1 year in patients with adolescent idiopathic scoliosis (AIS) and to develop simple recommendations for follow-up durations. Methods: Medical records of patients with AIS at two tertiary scoliosis referral centers were retrospectively reviewed for their DRU classification and major curve Cobb angles. Baseline DRU grades and Cobb angles with subsequent 1-year follow-up curve magnitudes were studied for scoliosis progression, which was defined as exacerbation of the Cobb angle by ≥ 6°. The relationship between DRU classification and scoliosis progression risk within 1 year was investigated. Patients were divided into three groups according to the Cobb angle (10°-19°, 20°-29°, ≥ 30°). Results: Of the 205 patients with 283 follow-up visits, scoliosis progression occurred in 86 patients (90 follow-up visits). Radius and ulna grades were significantly related to scoliosis progression (p < 0.001). R6, R7, and U5 grades were significantly related to scoliosis progression risk. The curve progression probability increased as the Cobb angle increased. Cobb angles ≥ 30°, with these grades, led to progression in > 80% of patients within 1 year. Curve progression was less likely for grades R9 and U7. Most patients with more mature DRU grades did not experience progression, even with Cobb angles ≥ 30°. Conclusion: With R6, R7, and U5, scoliosis may progress within a short period; therefore, careful follow-up with short intervals within 6 months is necessary. R9 and U7 may allow longer 1-year follow-up intervals due to the lower progression risk.
Description: 博士(医学)・甲第771号・令和3年3月15日
© Springer-Verlag GmbH Germany, part of Springer Nature 2020
This is a post-peer-review, pre-copyedit version of an article published in European spine journal. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00586-020-06441-4.
URI: http://hdl.handle.net/10564/3895
ISSN: 09406719
DOI: https://doi.org/10.1007/s00586-020-06441-4
Academic Degrees and number: 24601A771
Degree-granting date: 2021-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2020年度

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