High Risk of Mismatch Between Sanders and Risser Staging in Adolescent Idiopathic Scoliosis: Are We Guiding Treatment Using the Wrong Classification?

@article{Minkara2018HighRO,
  title={High Risk of Mismatch Between Sanders and Risser Staging in Adolescent Idiopathic Scoliosis: Are We Guiding Treatment Using the Wrong Classification?},
  author={Anas A Minkara and Nicole M Bainton and Masashi Tanaka and Justin W. Kung and Christopher Deallie and Alexandra E. Khaleel and Hiroko Matsumoto and Michael G. Vitale and Benjamin D Roye},
  journal={Journal of Pediatric Orthopaedics},
  year={2018}
}
BACKGROUND Despite known limitations, Risser staging has traditionally been the primary marker of skeletal maturity utilized in decision-making for treatment of adolescent idiopathic scoliosis (AIS. [] Key MethodMETHODS We reviewed the medical records of consecutive patients aged 10 to 18 referred to our institution for evaluation of AIS from January to June 2016 with a closed triradiate cartilage.
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TLDR
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TLDR
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TLDR
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TLDR
With existing growth potential various techniques, such as traditional growing rods, magnetically controlled growth rods and vertebral body tethering are available, after the end of the growth phase a fusion should be recommended for scoliosis >50°.
Reliable skeletal maturity assessment for an AIS patient cohort: external validation of the proximal humerus ossification system (PHOS) and relevant learning methodology.
STUDY DESIGN Validation of classification system. OBJECTIVES To externally validate the Proximal Humerus Ossification System (PHOS) as a reliable skeletal maturity scoring system and to assess the
What to Do After the Lengthening Period Is Over? Idiopathic Early-Onset Scoliosis Treated With Magec Rods:
The treatment of early-onset scoliosis with magnetic growing rods has been established, but the management at the end of the lengthening program is still controversial. The options available are
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References

SHOWING 1-10 OF 32 REFERENCES
Prediction of Curve Progression in Idiopathic Scoliosis: Validation of the Sanders Skeletal Maturity Staging System
TLDR
A larger cohort shows a strong predictive correlation between SS and initial Cobb angle for probability of curve progression in idiopathic scoliosis.
In Brief: The Risser Classification: A Classic Tool for the Clinician Treating Adolescent Idiopathic Scoliosis
Joseph C. Risser first described what now is called the Risser sign in 1958 [17]. Risser observed that the state of ossification of the iliac apophysis was associated with the state of a patient’s
A modified Risser grading system predicts the curve acceleration phase of female adolescent idiopathic scoliosis.
TLDR
No Risser stage was found to be a good clinical landmark for the beginning of the curve acceleration phase of adolescent idiopathic scoliosis, and moderate agreement between the United States and European grading systems was seen.
Predicting scoliosis progression from skeletal maturity: a simplified classification during adolescence.
TLDR
The simplified skeletal maturity scoring system is reliable and correlates more strongly with the behavior of idiopathic scoliosis than the Risser sign or Greulich and Pyle skeletal ages do.
Spinal growth and a histologic evaluation of the Risser grade in idiopathic scoliosis.
TLDR
The findings of significant endplate growth activity, even in patients with Risser Grade 4, make it unlikely that the crankshaft phenomenon is caused purely by longitudinal spinal growth.
The Natural History of Idiopathic Scoliosis Before Skeletal Maturity
TLDR
A retrospective review of 326 female patients with untreated idiopathic scoliosis was performed to determine what factors might be useful in predicting the risk of curve progression and predictive indicators included gender, curve patterns, and severity and growth potential.
The Interobserver and Intraobserver Reliability of the Sanders Classification Versus the Risser Stage
TLDR
The Sanders classification had moderate reliability with respect to physicians at various levels of training and had good reliability withrespect to attending spine surgeons and Interestingly, the Risser staging was found to have less interobserver and intraobserver reliability overall.
The prediction of curve progression in untreated idiopathic scoliosis during growth.
TLDR
The incidence of curve progression was found to be related to the pattern and magnitude of the curve, the patient's age at presentation, the Risser sign, and the patients' menarchal status.
Relationship of Peak Height Velocity to Other Maturity Indicators in Idiopathic Scoliosis in Girls*
TLDR
The growth peak was blunted when chronological age, menarchal age, and Risser sign were used to predict growth; this indicated that these maturity scales grouped the patients poorly in terms of growth.
Correlates of the Peak Height Velocity in Girls With Idiopathic Scoliosis
TLDR
The PHV is the most useful known maturity marker in idiopathic scoliosis and Tanner stages, IGF-1, estradiol levels, and the appearance of the epiphyses on a skeletal age radiograph are useful in determining status before or after PHV.
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