| Objective. To study whether the receptor activator of nuclear factor-κB (RANK) gene polymorphisms are associated with the susceptibility of adolescent idiopathic scoliosis (AIS).Methods.450 AIS girls and 400 age-matched healthy girls from Februry 2009 to July 2013 were recruited in this study, of which the average ages were 14.8±2.9 years (range,10-18 years) and 15.1±2.3 years (range,10-17 years), respectively. Only AIS girls with Cobb angles larger than 20° were included in this study. The anthropometric parameters including height, weight and body mass index (BMI) were available for all AIS girls. The rs1805034 and rs35211496 were selected as tagSNPs to cover all of the polymorphisms on RANK based on the recently released HapMap data. Genotyping was performed with polymerase chain reaction (PCR)-based invader assay with the probe sets designed and synthesized by the Third Wave. The genotyping results were read with the ABI PRISM7900HT sequence detection system (Applied Biosystems, Foster City, CA). Twenty percents of the samples were randomly selected to validate the reproducibility of the genotyping results. Comparison of genotyping results between 2 groups were performed using the x2 while one-way ANOVA tests were used for the comparison of Cobb angles and BMI between AIS girls with different genotyping.Results. The rs1805034 and rs35211496 were successfully genotyped, of which no significant difference of genotype frequencies from the Hardy-Weinberg equilibrium test was noted for the AIS patients or the normal controls (P>0.05). There was no significant difference of genotype and allele frequencies of rs 1805034 and rs35211496 between the AIS girls and normal controls (P>0.05). By one-way ANOVA test, rs 1805034 and rs35211496 were not associated with Cobb angles or BMI (P>0.05).Conclusion. The RANK gene polymorphisms are not significantly associated with the occurrence of AIS. There was no significant association between RANK gene polymorphisms and Cobb angles as well as BMI in AIS.Objective. To compare the predictive values of spine growth velocity(SGV) and height velocity (HV) in the prediction of Cobb angle velocity (AV) in adolescent idiopathic scoliosis (AIS), and to evaluate whether SGV is a good predictor for curve progression in AIS.Methods. In this retrospective study, pre-pubertal AIS girls with single right thoracic curve receiving standardized brace treatment were reviewed. All patients had curve progression more than 5°. The chronologic age, standing height, Risser Sign, spinal length and Cobb angles were recorded. The HV, SGV and AV of each visit were calculated and the peak height velocity (PHV) and peak spinal growth velocity (PSGV) were identified for each patient. Spearman coefficients were used for correlation analysis. Multiple linear regression analysis was used to analyze the correlated factors of AV while logistic regression analysis was applied for the high risk factors of AV more than 5° per year.Results. A total of 26 AIS girls were reviewed. The Cobb angles of main curve at initial visit and last follow-up were 24.1±3.3° and 35.8±7.9°,respectively. The average AV was 6.3±8.9°/year during whole follow-up.The average PHV and PSGV were 9.8±3.5 cm/year and 40.9±19.2 mm/year, respectively. Multiple linear regression analysis showed that AV was significantly correlated with SGV (B=0.226, P=0.001) rather than HV (B=0.173,P=0.268).Logistic regression analysis revealed that PSGV (OR=4.479,P=0.001)indicated the high risk of AV more than 5° per year while PHV (OR=2.013,P=0.102) did not enter the predictive model.Conclusions. Cobb angle velocity was more significantly associated with the spinal growth velocity than height velocity. High spinal growth velocity indicated the high risk of curve progression.Objective. To compare the predictive values of initial angle reduction velocity (ARV) and initial correction rate (CR) for curve progression in adolescent idiopathic scoliosis (AIS) patients, and to propose the ideal cut-off values of initial ARV for the prediction of curve progression.Methods. In this retrospective study, AIS girls undergoing standardized brace treatment were regularly followed up every 3-6 months. All the patients fulfilled the standardized SRS criteria for bracing, of which the demographics and Cobb angles of each visit were reviewed. The initial ARV and CR were identified for each patient. Finally, the patients were divided into progressive group (≥6°) and non-progressive group (<6°) according to their final bracing outcomes. Comparison analysis was performed using independent t test while logistic regression analysis was used to compare the predictive values of initial ARV and initial CR for curve progression.Results. A total of 95 patients were included in the study, of which 76 were in non-progressive group and 19 in progressive group.There were significant differences between non-progressive and progressive groups in terms of initial ARV (12.8±21.4°/year VS -5.4±15.2°/year, P=0.001) and initial CR (12.1%±20.7% VS-5.8%±18.0%, P=0.001). The logistic regression model showed that age at initial visit (OR=1.742, P=0.043) and initial ARV (OR=1.057, P=0.002) significantly predicted the high risk of curve progression while the predictive value of initial CR was not statistically significant (P=0.601). The ideal cut-off value of initial ARV was set as 10°/year (OR=8.959, P=0.005) for the prediction of curve progression.Conclusions. The initial ARV is better than CR for the prediction of curve progression in AIS. At the second visit following the prescription of brace, initial ARV lower than 10° per year significantly indicates the high risk of curve progression.Objective. To correlate the distal radius and ulna (DRU) stages with several growth potential indicators and to evaluate the predictive value of DRU system for curve progression in braced adolescent idiopathic scoliosis (AIS) patients.Methods. This was a consecutive longitudinal study including physically immature AIS girls with main thoracic curve receiving standardized bracing treatment and were regularly followed up every 3-6 months until brace weaning. The following data of each visit were collected:chronologic age, height, Cobb angle, spinal length, Risser sign, digital skeletal age (DSA) scores and DRU scores.The height velocity (HV), angle velocity (AV)and spine growth velocity (SGV) of each visit were calculated. The correlation among radius stage, ulna stage, Risser sign, height, spinal length, HV, SGV and AV were studied.Results. Forty braced AIS girls were reviewed. The average age at the first visit was 11.1±1.5 years. The average values of initial DRU scores were R6.5±1.1 and U4.5±1.2 for radius and ulna, respectively. Correlation analysis showed excellent linear correlation between the stages of radius and ulna (r=0.723, P<0.001). Both R7-R9 and U5-U7 were associated with DSA score between 400-500, high HV, high SGV and high AV.Conclusions. The radius stages R7-R9 and ulna stages U5-U7 are associated with the high height velocity, high spine growth velocity and high angle velocity. Either the radius stage or the ulna stage could serve as a good predictive indicator for the growth potential and curve progression in braced AIS patients.Objective. To investigate the curve progression after brace weaning in adolescent idiopathic scoliosis (AIS) girls using the Scoliosis Research Society (SRS) standard criteria, and to evaluate the indicators for curve progression after brace weaning.Methods. Two hundred AIS girls fulfilling the SRS bracing criteria were included with an average age of 12.08±1.2 years. All the patients were followed up regularly until at least 2 years after brace weaning. The demographics and radiographs at initial visit, brace weaning,6m after weaning, 1y after weaning,2y after weaning and last follow-up were available for each patient. At each time point, the following parameters were calculated:percentage of patients with curve progression>5°, percentage of patients who had surgery, percentage of patients with Cobb>45° and mean progressive magnitude and rate. Curve progression after brace weaning was separately defined as increase in Cobb angle>5° and curve magnitude>45° at 2 years after brace weaning. Correlation analysis was performed using the independent t test. Results. Compared with brace weaning, at 6m, 1y,2y and last follow-up after brace weaning, the percentages of patients with curve progression>5° were 25.0%,30.0%, 46.5% and 43.5%; the percentages of patients who had surgery were 0%,0%,1% and 1%;the percentages of patients with Cobb>45° were 2.7%,5.5%,8.2% and 12.0%; the mean progression magnitudes were 2.6±5.8°,3.5±5.8°,5.1±6.5° and 5.4±7.4°; the mean progression rates were 0.34±0.83°/m,0.16±0.56°/m,0.13±0.39°/m and 0.006±0.28°/m. Significant difference was found in Cobb angles at brace weaning (P<0.05) between non-progressive and progressive groups.Conclusion.43.5% AIS patients have curve progression after brace weaning and the highest rate of curve progression occurs within 6m after brace weaning. High Cobb angles at brace weaning indicates high risk of curve progression after brace weaning. |
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