Prognostic model development for risk of curve progression in adolescent idiopathic scoliosis: a prospective cohort study of 127 patients
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View abstract on PubMed
Summary
This summary is machine-generated.This study developed a survival model to predict adolescent idiopathic scoliosis curve progression. Key predictors include Risser stage, Cobb angle, and patient-reported spinal appearance, aiding in early intervention for scoliosis.
Area Of Science
- Orthopedics
- Biostatistics
- Pediatric Spine Surgery
Background
- Adolescent idiopathic scoliosis (AIS) is a common spinal deformity.
- Predicting curve progression in AIS is crucial for timely intervention.
- Existing prognostic models may not fully capture disease heterogeneity.
Purpose Of The Study
- To develop and internally validate a prognostic survival model for adolescent idiopathic scoliosis curve progression.
- Identify baseline variables that predict significant curve worsening.
- Enhance clinical decision-making for AIS management.
Main Methods
- Longitudinal prognostic cohort analysis of 135 patients (ages 9-17) with AIS.
- Cox proportional hazards regression (CoxPH) and machine learning models were used for development and validation.
- Prognostic outcome defined as >6° Cobb angle progression before skeletal maturity.
Main Results
- The final CoxPH model (n=127) demonstrated acceptable discriminative ability (concordance=0.79).
- Significant predictors of progression included Risser stage 0, larger Cobb angle, and higher patient-reported Spinal Appearance Questionnaire (pSAQ) scores.
- Treatment exposure was also a significant factor (HR 3.1, P=0.001).
Conclusions
- A prognostic model incorporating Risser stage, Cobb angle, and pSAQ effectively predicts >6° curve progression in AIS.
- Patient-reported outcomes via pSAQ may offer significant clinical value for prognosis.
- The model provides a robust tool for identifying at-risk adolescents.
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