Abstract：
OBJECTIVE: The aim of this study was to review the current evidence surrounding curve type and morphology on curve progression risk in adolescent idiopathic scoliosis (AIS).
METHODS: A comprehensive search was conducted by two independent reviewers on PubMed, Embase, Medline, and Web of Science to obtain all published information on morphological predictors of AIS progression. Search items included \'adolescent idiopathic scoliosis\', \'progression\', and \'imaging\'. The inclusion and exclusion criteria were carefully defined. Risk of bias of studies was assessed with the Quality in Prognostic Studies tool, and level of evidence for each predictor was rated with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. In all, 6,286 publications were identified with 3,598 being subjected to secondary scrutiny. Ultimately, 26 publications (25 datasets) were included in this review.
RESULTS: For unbraced patients, high and moderate evidence was found for Cobb angle and curve type as predictors, respectively. Initial Cobb angle > 25° and thoracic curves were predictive of curve progression. For braced patients, flexibility < 28% and limited in-brace correction were factors predictive of progression with high and moderate evidence, respectively. Thoracic curves, high apical vertebral rotation, large rib vertebra angle difference, small rib vertebra angle on the convex side, and low pelvic tilt had weak evidence as predictors of curve progression.
CONCLUSIONS: For curve progression, strong and consistent evidence is found for Cobb angle, curve type, flexibility, and correction rate. Cobb angle > 25° and flexibility < 28% are found to be important thresholds to guide clinical prognostication. Despite the low evidence, apical vertebral rotation, rib morphology, and pelvic tilt may be promising factors. Cite this article: Bone Joint J 2022;104-B(4):424-432.
METHODS: A comprehensive search was conducted by two independent reviewers on PubMed, Embase, Medline, and Web of Science to obtain all published information on morphological predictors of AIS progression. Search items included \'adolescent idiopathic scoliosis\', \'progression\', and \'imaging\'. The inclusion and exclusion criteria were carefully defined. Risk of bias of studies was assessed with the Quality in Prognostic Studies tool, and level of evidence for each predictor was rated with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. In all, 6,286 publications were identified with 3,598 being subjected to secondary scrutiny. Ultimately, 26 publications (25 datasets) were included in this review.
RESULTS: For unbraced patients, high and moderate evidence was found for Cobb angle and curve type as predictors, respectively. Initial Cobb angle > 25° and thoracic curves were predictive of curve progression. For braced patients, flexibility < 28% and limited in-brace correction were factors predictive of progression with high and moderate evidence, respectively. Thoracic curves, high apical vertebral rotation, large rib vertebra angle difference, small rib vertebra angle on the convex side, and low pelvic tilt had weak evidence as predictors of curve progression.
CONCLUSIONS: For curve progression, strong and consistent evidence is found for Cobb angle, curve type, flexibility, and correction rate. Cobb angle > 25° and flexibility < 28% are found to be important thresholds to guide clinical prognostication. Despite the low evidence, apical vertebral rotation, rib morphology, and pelvic tilt may be promising factors. Cite this article: Bone Joint J 2022;104-B(4):424-432.
摘要：
目的：本研究的目的是回顾目前关于青少年特发性脊柱侧凸（AIS）的曲线类型和形态有关曲线进展风险的证据。
方法：由PubMed的两名独立审稿人进行了全面搜索，Embase,Medline,和WebofScience获取有关AIS进展的形态学预测因子的所有已发布信息。搜索项目包括“青少年特发性脊柱侧弯”，\'进展\',和\'成像\'。仔细定义了纳入和排除标准。使用“预后研究质量”工具评估研究偏倚的风险，每个预测因子的证据水平用建议分级进行评级，评估,开发和评估(等级)方法。总之,确定了6,286种出版物，其中3,598种受到二次审查。最终,本综述包括26篇出版物(25个数据集)。
结果：对于无支架的患者，发现了Cobb角和曲线类型作为预测因子的高和中等证据，分别。初始Cobb角>25°和胸曲线可预测曲线进展。对于有支撑的病人，柔韧性<28%和有限的支架内矫正是预测进展的因素，有高证据和中等证据，分别。胸廓曲线,高根尖椎体旋转，大的肋骨椎骨角度差，凸侧的小肋骨椎骨角度，低骨盆倾斜作为曲线进展的预测因子的证据薄弱。
结论：对于曲线进展，对于Cobb角已经找到了有力且一致的证据,曲线类型,灵活性,和修正率。发现Cobb角>25°和柔韧性<28%是指导临床预后的重要阈值。尽管证据不足,根尖椎体旋转，肋骨形态,骨盆倾斜可能是有希望的因素。引用本文：骨关节J2022；104-B（4）：424-432。
方法：由PubMed的两名独立审稿人进行了全面搜索，Embase,Medline,和WebofScience获取有关AIS进展的形态学预测因子的所有已发布信息。搜索项目包括“青少年特发性脊柱侧弯”，\'进展\',和\'成像\'。仔细定义了纳入和排除标准。使用“预后研究质量”工具评估研究偏倚的风险，每个预测因子的证据水平用建议分级进行评级，评估,开发和评估(等级)方法。总之,确定了6,286种出版物，其中3,598种受到二次审查。最终,本综述包括26篇出版物(25个数据集)。
结果：对于无支架的患者，发现了Cobb角和曲线类型作为预测因子的高和中等证据，分别。初始Cobb角>25°和胸曲线可预测曲线进展。对于有支撑的病人，柔韧性<28%和有限的支架内矫正是预测进展的因素，有高证据和中等证据，分别。胸廓曲线,高根尖椎体旋转，大的肋骨椎骨角度差，凸侧的小肋骨椎骨角度，低骨盆倾斜作为曲线进展的预测因子的证据薄弱。
结论：对于曲线进展，对于Cobb角已经找到了有力且一致的证据,曲线类型,灵活性,和修正率。发现Cobb角>25°和柔韧性<28%是指导临床预后的重要阈值。尽管证据不足,根尖椎体旋转，肋骨形态,骨盆倾斜可能是有希望的因素。引用本文：骨关节J2022；104-B（4）：424-432。
