2023 Volume 14 Issue 11 Pages 1377-1382
Introduction: Brace treatment for adolescent idiopathic scoliosis (AIS) is usually indicated for patients with Risser sign grade 0-3, but not for above grade 4. However, we occasionally see patients whose curves progress even in patients with Risser sign grade 4. We examine Cobb angle progression and risk factors in Risser sign grade 4 cases of AIS.
Methods: From January 2016 to December 2020, 42 AIS patients with Risser sign grade 4 at the first visit to our clinic and were followed up for at least 1 year were included. Patient background, physical findings, and radiological measurements including the Cobb angles were evaluated. Patients were divided into progressive and non-progressive groups to compare their risk factors of scoliosis.
Results: Eight patients were in the progressive group and 34 were in the non-progressive group. In the progressive group, the Cobb angle increased by 7.1 degrees, from 28.7 to 35.8 degrees. The time since menarche was significantly shorter in the progressive group (9.7 months) than in the non-progressive group (24.2 months) (P=0.003). Growth in height was significantly greater in the progressive group (+2.9 cm) than in the non-progressive group (+1.8 cm) (P = 0.02). There were no differences in the other factors.
Conclusions: In this study, curves progressed in approximately 20% of patients with Risser sign grade 4. In cases with short time since menarche or potential for height growth, AIS patients with Risser sign grade 4 may need to take brace therapy.
