My daughter's orthopedic surgeon stated that it had been proven that kids whose curves progressed after reaching skeletal maturity were not done with their growth.
Here are a couple of research items showing that growth can continue beyond skeletal maturity when judged by both Risser and by fusion of the epiphyses of the hand and wrist.
These are both based on older observations, so I wonder why many orthopedic surgeons don't take this into account when determining the time to stop bracing? Is this just relying on odds, and it's just unfortunate for those kids who don't follow the average growth patterns? Shouldn't they be relying on cessation of vertical growth also?
Spinekids has numerous kids this has happened to. Perhaps the doctors could show their patients sideshift exercises during weaning of the brace to help minimize any further progression if they feel the kid can't take bracing any more.
Anybody have any knowledge of or insight into the reasons?
The pathogenesis of adolescent idiopathic scoliosis
A systematic review of the literature
Kouwenhoven JWM
Castelein RM
"Contrary to the findings of Risser and Ferguson, complete ossification of the iliac apophysis did not always correlate with the cessation of vertebral growth. Several authors reported progression of scoliotic curves after skeletal maturity, diagnosed by Risser’s method."
(This is an interesting paper, by the way, in case anyone is interested in a review of the possible causes of scoliosis).
Spine (Phila Pa 1976). 1992 Apr;17(4):437-40.
Growth beyond skeletal maturity.
Howell FR, Mahood JK, Dickson RA.
University Department of Orthopaedic Surgery, St. James's University Hospital, Leeds, United Kingdom.
Serial measurements of standing and sitting height of children show that growth continues beyond the age of skeletal maturity when judged by the fusion of the epiphyses of the hand and wrist. Most of this increase occurs in the sitting height, largely reflecting spinal growth, and may account for the known progression potential of idiopathic scoliosis beyond the attainment of skeletal maturity.
http://journals.lww.com/spinejournal...turity.10.aspx
Here are a couple of research items showing that growth can continue beyond skeletal maturity when judged by both Risser and by fusion of the epiphyses of the hand and wrist.
These are both based on older observations, so I wonder why many orthopedic surgeons don't take this into account when determining the time to stop bracing? Is this just relying on odds, and it's just unfortunate for those kids who don't follow the average growth patterns? Shouldn't they be relying on cessation of vertical growth also?
Spinekids has numerous kids this has happened to. Perhaps the doctors could show their patients sideshift exercises during weaning of the brace to help minimize any further progression if they feel the kid can't take bracing any more.
Anybody have any knowledge of or insight into the reasons?
The pathogenesis of adolescent idiopathic scoliosis
A systematic review of the literature
Kouwenhoven JWM
Castelein RM
"Contrary to the findings of Risser and Ferguson, complete ossification of the iliac apophysis did not always correlate with the cessation of vertebral growth. Several authors reported progression of scoliotic curves after skeletal maturity, diagnosed by Risser’s method."
(This is an interesting paper, by the way, in case anyone is interested in a review of the possible causes of scoliosis).
Spine (Phila Pa 1976). 1992 Apr;17(4):437-40.
Growth beyond skeletal maturity.
Howell FR, Mahood JK, Dickson RA.
University Department of Orthopaedic Surgery, St. James's University Hospital, Leeds, United Kingdom.
Serial measurements of standing and sitting height of children show that growth continues beyond the age of skeletal maturity when judged by the fusion of the epiphyses of the hand and wrist. Most of this increase occurs in the sitting height, largely reflecting spinal growth, and may account for the known progression potential of idiopathic scoliosis beyond the attainment of skeletal maturity.
http://journals.lww.com/spinejournal...turity.10.aspx
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