A multicenter analysis of factors associated with change in height after adolescent idiopathic scoliosis deformity surgery in 447 patients

Clinical article

View More View Less
  • 1 Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts;
  • 2 Department of Orthopedics, Shriners Hospitals for Children, Philadelphia, Pennsylvania;
  • 3 Department of Orthopedics, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York;
  • 4 Setting Scoliosis Straight Foundation; and
  • 5 Pediatric Orthopedic and Scoliosis Center, Rady Children's Hospital, San Diego, California
Restricted access

Purchase Now

USD  $45.00

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

Object

In the surgical management of adolescent idiopathic scoliosis (AIS), patients are often preoperatively informed that they will gain height as a result of their surgery. However, current estimations conflict significantly and do not have any clinical correlation. The authors developed a formula that would predict postoperative gains in height after deformity correction in AIS.

Methods

A large, multicenter, prospective database was retrospectively queried for AIS patients with Lenke Type 1, 2, or 3 curves having undergone posterior spinal fusion alone. A univariate and multivariate analysis was performed to identify which factors contributed significantly to changes in height.

Results

Four hundred forty-seven patients were included in the series. Factors correlating with changes in postoperative height included: upper thoracic curve magnitude, main thoracic curve magnitude, lumbar curve magnitude, T2–12 kyphosis, T5–12 kyphosis, curve flexibility, number of levels fused, presence of Ponte osteotomies, total preoperative coronal Cobb angle, change in coronal curve magnitude, total preoperative sagittal curvature, change in sagittal curvature, and thoracic curve correction.

When combined in a multivariate regression analysis the following variables remained significant: thoracic curve magnitude (p < 0.01), number of levels fused (p < 0.01), change in total sagittal curvature (p < 0.01), and the presence of osteotomies (p = 0.03). The contribution from the thoracic curve magnitude was significantly greater than any of the other parameters identified (R2 = 0.140). Change in height (in cm) = ([thoracic curve magnitude × 0.039] + [number of levels fused × 0.193] − [change in sagittal curvature × 0.033] + [x × 0.375]) − 1.858, where x = 1 if 1 or more osteotomies were performed and x = 0 if no osteotomy was performed.

Conclusions

The authors' results suggest that changes in the coronal plane contribute more significantly to height changes than those in the sagittal plane and approximately 0.39 cm of height gain can be expected for each 10° of coronal curve preoperatively. Unfortunately, a significant fraction of the postoperative height changes cannot be predicted by currently measured parameters.

Abbreviation used in this paper:AIS = adolescent idiopathic scoliosis.

Spine - 1 year subscription bundle (Individuals Only)

USD  $369.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address correspondence to: Steven W. Hwang, M.D., 800 Washington Street, Box 178, Boston, Massachusetts 02111. email: stevenhwang@hotmail.com.

Please include this information when citing this paper: published online January 18, 2013; DOI: 10.3171/2012.12.SPINE12870.

  • 1

    Archer IA, & Dickson RA: Stature and idiopathic scoliosis. A prospective study. J Bone Joint Surg Br 67:185188, 1985

  • 2

    Bjure J, , Grimby G, & Nachemson A: Correction of body height in predicting spirometric values in scoliotic patients. Scand J Clin Lab Invest 21:191192, 1968

    • Search Google Scholar
    • Export Citation
  • 3

    Carr AJ, , Jefferson RJ, & Turner-Smith AR: Family stature in idiopathic scoliosis. Spine (Phila Pa 1976) 18:2023, 1993

  • 4

    Carr AJ, , Jefferson RJ, , Weisz I, & Turner-Smith AR: Correction of body height in scoliotic patients using ISIS scanning. Spine (Phila Pa 1976) 14:220222, 1989

    • Search Google Scholar
    • Export Citation
  • 5

    Grivas TB, , Arvaniti A, , Maziotou C, , Manesioti MM, & Fergadi A: Comparison of body weight and height between normal and scoliotic children. Stud Health Technol Inform 91:4753, 2002

    • Search Google Scholar
    • Export Citation
  • 6

    Grivas TB, , Samelis P, , Polyzois BD, , Giourelis B, & Polyzois D: School screening in the heavily industrialized area—is there any role of industrial environmental factors in idiopathic scoliosis prevalence?. Stud Health Technol Inform 91:7680, 2002

    • Search Google Scholar
    • Export Citation
  • 7

    Risser JC: The Iliac apophysis; an invaluable sign in the management of scoliosis. Clin Orthop 11:111119, 1958

  • 8

    Willner S: A study of height, weight and menarche in girls with idiopathic structural scoliosis. Acta Orthop Scand 46:7183, 1975

  • 9

    Ylikoski M: Height of girls with adolescent idiopathic scoliosis. Eur Spine J 12:288291, 2003

Metrics

All Time Past Year Past 30 Days
Abstract Views 318 65 12
Full Text Views 135 20 2
PDF Downloads 166 14 1
EPUB Downloads 0 0 0