Abstract：
The diagnosis of adolescent idiopathic scoliosis requires clinical and radiographic evaluation; the management options vary depending on the severity of the curve and potential for progression. Identifying predictors of scoliosis progression is crucial to avoid incorrect management; clinical and radiographic factors have been studied as potential predictors. The present study aims to review the literature on radiological indexes for the peak height velocity or curve acceleration phase to help clinicians manage treatment of patients with adolescent idiopathic scoliosis.
This systematic review was carried out in accordance with Preferential Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search was carried out including only peer-reviewed articles written in English that described the radiological indexes assessing skeletal maturity in patients with adolescent idiopathic scoliosis and evaluated their correlation with curve progression, expressed as peak height velocity and/or curve acceleartion phase.
Thirteen studies were included and showed promising results in terms of reliable radiological indexes. Risser staging gives a general measure of skeletal maturity, but it cannot be used as a primary index for driving the treatment of patients with adolescent idiopathic scoliosis since more reliable indexes are available.
Skeletal maturity quantification for adolescent idiopathic scoliosis has the potential to significantly modify disease management. However, idiopathic scoliosis is a complex and multifactorial disease: therefore, it is unlikely that a single index will ever be sufficient to predict its evolution. Therefore, as more adolescent idiopathic scoliosis progression-associated indexes are identified, a collective scientific effort should be made to develop a therapeutic strategy based on reliable and reproducible algorithms.
This systematic review was carried out in accordance with Preferential Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search was carried out including only peer-reviewed articles written in English that described the radiological indexes assessing skeletal maturity in patients with adolescent idiopathic scoliosis and evaluated their correlation with curve progression, expressed as peak height velocity and/or curve acceleartion phase.
Thirteen studies were included and showed promising results in terms of reliable radiological indexes. Risser staging gives a general measure of skeletal maturity, but it cannot be used as a primary index for driving the treatment of patients with adolescent idiopathic scoliosis since more reliable indexes are available.
Skeletal maturity quantification for adolescent idiopathic scoliosis has the potential to significantly modify disease management. However, idiopathic scoliosis is a complex and multifactorial disease: therefore, it is unlikely that a single index will ever be sufficient to predict its evolution. Therefore, as more adolescent idiopathic scoliosis progression-associated indexes are identified, a collective scientific effort should be made to develop a therapeutic strategy based on reliable and reproducible algorithms.
摘要：
背景：青少年特发性脊柱侧凸的诊断需要临床和影像学评估；治疗方案因曲线的严重程度和进展可能性而异。确定脊柱侧凸进展的预测因素对于避免不正确的治疗至关重要；已经研究了临床和影像学因素作为潜在的预测因素。本研究旨在回顾有关峰值高度速度或曲线加速阶段的放射学指标的文献，以帮助临床医生管理青少年特发性脊柱侧凸患者的治疗。
方法：本系统评价按照系统评价和荟萃分析（PRISMA）指南的优先报告项目进行。进行了搜索，仅包括同行评审的英文文章，这些文章描述了评估青少年特发性脊柱侧凸患者骨骼成熟度的放射学指标，并评估了它们与曲线进展的相关性。表示为峰高速度和/或曲线加速相位。
结果：纳入了13项研究，在可靠的放射学指标方面显示了有希望的结果。Risser分期给出了骨骼成熟度的一般量度，但由于有更可靠的指标，因此它不能作为驱动青少年特发性脊柱侧凸患者治疗的主要指标。
结论：青少年特发性脊柱侧凸的骨骼成熟度量化有可能显著改变疾病管理。然而,特发性脊柱侧凸是一种复杂的多因素疾病：因此，单个指数不太可能足以预测其演变。因此,随着越来越多的青少年特发性脊柱侧凸进展相关指标的确定，应集体做出科学努力,制定基于可靠和可重复算法的治疗策略.
方法：本系统评价按照系统评价和荟萃分析（PRISMA）指南的优先报告项目进行。进行了搜索，仅包括同行评审的英文文章，这些文章描述了评估青少年特发性脊柱侧凸患者骨骼成熟度的放射学指标，并评估了它们与曲线进展的相关性。表示为峰高速度和/或曲线加速相位。
结果：纳入了13项研究，在可靠的放射学指标方面显示了有希望的结果。Risser分期给出了骨骼成熟度的一般量度，但由于有更可靠的指标，因此它不能作为驱动青少年特发性脊柱侧凸患者治疗的主要指标。
结论：青少年特发性脊柱侧凸的骨骼成熟度量化有可能显著改变疾病管理。然而,特发性脊柱侧凸是一种复杂的多因素疾病：因此，单个指数不太可能足以预测其演变。因此,随着越来越多的青少年特发性脊柱侧凸进展相关指标的确定，应集体做出科学努力,制定基于可靠和可重复算法的治疗策略.
