Value of different Risser grading systems in determining growth potentiality of girls with adolescent idiopathic scoliosis
10.3760/cma.j.issn.0253-2352.2012.01.002
- VernacularTitle:不同Risser征定义对女性青少年特发性脊柱侧凸生长潜能评估的比较
- Author:
Yong QIU
;
Weijun WANG
;
Xin ZHENG
;
Bin WANG
;
Zezhang ZHU
;
Feng ZHU
- Publication Type:Journal Article
- Keywords:
Scoliosis;
Adolescent;
Growth;
Histology
- From:
Chinese Journal of Orthopaedics
2012;32(1):7-12
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo analyze the differences of United States (US) and France (Fr) Risser grading systems in determining the growth potentiality of girls with adolescent idiopathic scoliosis (AIS).Methods Girls with AIS undergoing posterior spinal correction with autogenous bone graft were recruited.The Risser grades were recorded for the non-dominant side iliac crest apophysis according to the US and Fr grading systems.Iliac crest cartilage biopsies were harvested during surgery then standard histologic grades(HGs) of proliferation activity of iliac cartilage were analyzed on histological section.The agreement of two grading systems was analyzed by kappa statistics while the correlation between Risser grades and HGs were analyzed by Spearman correlation analysis.Receiver Operating Characteristic (ROC) curve was employed for selecting the best parameter in determining growth cessation of girls with AIS.ResultsFifty-three AIS girls with an average age of 14.0 years were recruited.The agreement of two grading systems was poor.The US system showed higher correlation with HGs compared to Fr system.Growth cessation could be determined by Risser grade 5 of US system or Risser grade 4 of Fr system,also older than 16 years or three years after menarche.When combining the results of ROC curve analysis,the Risser grade 4-5 of US system with two years after menarche could be used in determining growth cessation with the highest sensitivity,specificity and accuracy.Furthermore,the mean age of patients with growth cessation determined by this method was 15.2 years,showed 0.9-1.4 years earlier than the age determined by other methods.ConclusionThe US Risser grading system is better in determining maturity of AIS girls compared to Fr Risser grading system.By combining years since menarche,the accuracy of Risser grades in determining growth cessation could be enhanced,and the time of weaning from a brace could be advanced.
