{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:56:57Z","timestamp":1762869417654,"version":"3.37.3"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T00:00:00Z","timestamp":1723680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The management of adolescent idiopathic scoliosis (AIS) curves between 40 and 50\u00b0 is controversial. Here, we investigated the prognostic significance of simple radiographic rotational parameters to identify curves of this magnitude with accelerated deterioration following skeletal maturity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Seventy-three patients were identified with AIS and Cobb angles of the major curve between 40 and 50\u00b0 at skeletal maturity. We defined fast\u00a0progressive curves as those increasing by\u2009\u2265\u20092\u00b0 per year after skeletal maturity. From the apical vertebra of the major curve upon presentation and skeletal maturity, we determined the modified Nash\u2013Moe index (\u00d7100), and from thoracic major curves, the Rib Index. <jats:italic>T<\/jats:italic> tests were performed to compare fast-progressive curves with those that deteriorated by\u2009&lt;\u20092\u00b0 per year. Receiver operator characteristic (ROC) curves were plotted to establish optimal cutoffs, sensitivity, and specificity measures for rotational parameters.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The average duration of follow-up post was 11.8\u2009\u00b1\u20097.3\u00a0years. Thirteen out of seventy-three patients were fast progressors. The modified Nash\u2013Moe index was similar between groups at presentation (<jats:italic>p<\/jats:italic>\u2009=\u20090.477) but significantly higher in fast progressors than non-fast progressors at maturity for major thoracic curves (25.40\u2009\u00b1\u20096.60 vs. 19.20\u2009\u00b1\u20094.40, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Rib Index values were also higher among fast progressors at skeletal maturity (2.50\u2009\u00b1\u20090.90 vs. 1.80\u2009\u00b1\u20090.60, <jats:italic>p<\/jats:italic>\u2009=\u20090.026). An ROC curve for a modified Nash\u2013Moe index of 0.235 for thoracic curves achieved an area under the curve (AUC) of 0.76 for discriminating fast progressors. A threshold of 1.915 for Rib Index at maturity achieved an AUC of 0.72 for discriminating fast progressors. In combining both rotational parameters, an AUC of 0.81 was achieved.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>These simple rotational parameters may be useful to predict fast progression in 40\u201350\u00b0 AIS curves following skeletal maturity indicated for early fusion, but further validation\u00a0upon larger cohorts and non-thoracic major\u00a0curves is required.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s43390-024-00949-1","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T09:02:24Z","timestamp":1723712544000},"page":"1729-1734","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognosticating accelerated deterioration in skeletally mature adolescent idiopathic scoliosis curves of 40\u201350\u00b0 using uniplanar radiographic measures of axial rotation"],"prefix":"10.1007","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3480-371X","authenticated-orcid":false,"given":"Graham Ka-Hon","family":"Shea","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel Yan-Lik","family":"Ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changmeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guodong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,15]]},"reference":[{"issue":"3","key":"949_CR1","first-page":"193","volume":"89","author":"JP Horne","year":"2014","unstructured":"Horne JP, Flannery R, Usman S (2014) Adolescent idiopathic scoliosis: diagnosis and management. 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