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Related Concept Videos

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Changes in the Appendicular Skeleton with Age

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Related Experiment Video

Updated: Jun 18, 2026

Clinical Efficacy of an Innovative Multidimensional Traction Therapy in Moderate Adolescent Idiopathic Scoliosis
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Published on: February 10, 2026

Discrepancy Rates Between Skeletal Maturity Assessment Systems in Adolescent Idiopathic Scoliosis: A Systematic

Bo Xiang Bryan Neo1, Jeremie Shun Hong Choo1, Hee-Kit Wong2

  • 1Yong Loo Lin School of Medicine, National University of Singapore.

Journal of Pediatric Orthopedics
|June 17, 2026
PubMed
Summary

Skeletal maturity assessment systems for adolescent idiopathic scoliosis (AIS) show significant discrepancies, potentially impacting treatment decisions. The Risser scale may overestimate maturity, while Sanders Maturity Scale (SMS) and cervical vertebral maturation (CVM) show better correlation with growth.

Keywords:
Risser classificationSanders maturity scaleadolescent idiopathic scoliosiscervical vertebral maturationdiscrepancyskeletal maturity

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Published on: December 2, 2025

Area of Science:

  • Orthopedics
  • Radiology
  • Pediatric Spine Surgery

Background:

  • Accurate skeletal maturity assessment is crucial for adolescent idiopathic scoliosis (AIS) management.
  • Growth potential influences curve progression risk and intervention timing.
  • Discordance among current classification systems can lead to suboptimal clinical decisions.

Purpose of the Study:

  • To systematically review and meta-analyze the discrepancy rates between different skeletal maturity classification systems in AIS.
  • To identify which systems exhibit greater agreement with clinical growth parameters.

Main Methods:

  • Systematic review and meta-analysis following PRISMA guidelines.
  • Searched PubMed, Scopus, Embase, Cochrane Library, and Web of Science.
  • Included studies comparing two or more skeletal maturity systems in AIS.
  • Estimated pooled discrepancy rates using random-effects meta-analyses.

Main Results:

  • Thirteen studies were included; 9 underwent meta-analysis.
  • Risser vs. Sanders Maturity Scale (SMS) showed overall discrepancy of 16.1%.
  • Risser vs. Cervical Vertebral Maturation (CVM) had a 25.0% overall discrepancy.
  • Significant variability noted with other systems.

Conclusions:

  • Substantial discordance exists among AIS skeletal maturity assessment systems.
  • Risser staging may overestimate skeletal maturity.
  • SMS and CVM appear more aligned with clinical growth parameters.
  • A multimodal approach with granular indices may enhance treatment timing and outcomes.