Skip to main content
Journal cover image

Staying ahead of the curve: the use of spinopelvic parameters to predict curve progression and bracing success in adolescent idiopathic scoliosis.

Publication ,  Journal Article
Catanzano, AA; Esposito, VR; Dial, BL; Wu, CJ; Hinton, ZW; Risoli, TJ; Green, CL; Fitch, RD; Lark, RK
Published in: Spine Deform
December 2020

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To investigate radiographic sagittal and spinopelvic parameters of patients with adolescent idiopathic scoliosis (AIS) treated with bracing and assess differences among those treated successfully and unsuccessfully. AIS is a three-dimensional deformity of the spine, sharing an intricate relationship with pelvic morphology. However, the most relevant predictors of curve progression have historically been coronal parameters and skeletal maturity. Sagittal and spinopelvic parameters have not been thoroughly investigated as predictors of curve progression and brace treatment success. METHODS: Retrospective review of AIS patients who underwent brace treatment. Coronal Cobb angles (CC), pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), thoracic kyphosis (TK), lumbar lordosis (LL), and thoracic spinopelvic angles (T1SP, T9SP) were measured prior to initiation of bracing. The sagittal and spinopelvic parameters of patients requiring surgical treatment due to curve progression were compared to those treated successfully with bracing. RESULTS: No significant differences were found for age, race, gender, Risser category (0/1 vs 2/3), initial CC, TK, LL, T1SP, or T9SP between cohorts. The cohort requiring surgery had significantly lower PI (p  <  0.001, 42.0 v. 54.6), SS (p  <  0.001, 37.0 v. 44.5), and PT (p  =  0.003, 5.0 v. 10.2) compared to those successfully treated with bracing. Multivariable models controlling for Risser stage and Initial CC revealed the odds for successful brace treatment increases with an increase in PI (OR  =  1.47, CI 1.18-1.83, p  <  0.001), SS (OR  =  1.26, CI 1.07-1.48, p  =  0.006), and PT (OR  =  1.43, CI 1.09-1.86, p  =  0.006) (Table 3). The odds of successful brace treatment is given per one-unit increase for each radiographic measure after adjusting for Initial CC and Risser sign which were forced into each multivariable model. CONCLUSIONS: Spinopelvic parameters may indicate potential spine adaptability and skeletal maturity. For these reasons, we proposed that spinopelvic parameters may be a potential predictor of curve progression and brace treatment success. Our results demonstrated a higher risk of curve progression with lower PI, PT, or SS which support this hypothesis, however, given the small sample size and high variability, the magnitude of this effect should be viewed with caution and should serve as an impetus to further, larger scale studies to investigate the value spinopelvic parameters in curve progression and bracing efficacy. LEVEL OF EVIDENCE: IV.

Duke Scholars

Published In

Spine Deform

DOI

EISSN

2212-1358

Publication Date

December 2020

Volume

8

Issue

6

Start / End Page

1213 / 1222

Location

England

Related Subject Headings

  • Treatment Outcome
  • Spine
  • Scoliosis
  • Retrospective Studies
  • Radiography
  • Predictive Value of Tests
  • Pelvis
  • Male
  • Humans
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Catanzano, A. A., Esposito, V. R., Dial, B. L., Wu, C. J., Hinton, Z. W., Risoli, T. J., … Lark, R. K. (2020). Staying ahead of the curve: the use of spinopelvic parameters to predict curve progression and bracing success in adolescent idiopathic scoliosis. Spine Deform, 8(6), 1213–1222. https://doi.org/10.1007/s43390-020-00159-5
Catanzano, Anthony A., Valentine R. Esposito, Brian L. Dial, Christine J. Wu, Zoe W. Hinton, Thomas J. Risoli, Cynthia L. Green, Robert D. Fitch, and Robert K. Lark. “Staying ahead of the curve: the use of spinopelvic parameters to predict curve progression and bracing success in adolescent idiopathic scoliosis.Spine Deform 8, no. 6 (December 2020): 1213–22. https://doi.org/10.1007/s43390-020-00159-5.
Catanzano AA, Esposito VR, Dial BL, Wu CJ, Hinton ZW, Risoli TJ, et al. Staying ahead of the curve: the use of spinopelvic parameters to predict curve progression and bracing success in adolescent idiopathic scoliosis. Spine Deform. 2020 Dec;8(6):1213–22.
Catanzano, Anthony A., et al. “Staying ahead of the curve: the use of spinopelvic parameters to predict curve progression and bracing success in adolescent idiopathic scoliosis.Spine Deform, vol. 8, no. 6, Dec. 2020, pp. 1213–22. Pubmed, doi:10.1007/s43390-020-00159-5.
Catanzano AA, Esposito VR, Dial BL, Wu CJ, Hinton ZW, Risoli TJ, Green CL, Fitch RD, Lark RK. Staying ahead of the curve: the use of spinopelvic parameters to predict curve progression and bracing success in adolescent idiopathic scoliosis. Spine Deform. 2020 Dec;8(6):1213–1222.
Journal cover image

Published In

Spine Deform

DOI

EISSN

2212-1358

Publication Date

December 2020

Volume

8

Issue

6

Start / End Page

1213 / 1222

Location

England

Related Subject Headings

  • Treatment Outcome
  • Spine
  • Scoliosis
  • Retrospective Studies
  • Radiography
  • Predictive Value of Tests
  • Pelvis
  • Male
  • Humans
  • Follow-Up Studies