Interval-Based International Multicenter Validation of the Distal Radius and Ulna Classification for Growth Velocity and Curve Progression in Adolescent Idiopathic Scoliosis.

Authors

Hideyuki Arima, Yu Yamato, Chris Yin Wei Chan, Chee Kidd Chiu, Mun Keong Kwan, Shinji Takahashi, Yusuke Hori, Hideki Sudo, Katsuhisa Yamada, Shu-Hua Yang, Ming-Hsiao Hu, Chih-Wei Chen, Jason Pui Yin Cheung, Prudence Wing Hang Cheung, Sophia Sze, Yat Wa Wong, Keith Dip Kei Luk, Daisuke Sakai, Daisuke Kudo, Wataru Saito, Gabriel Liu, Leok Lim Lau, Ajoy Shetty, Hideki Shigematsu

Published in

Global spine journal. Pages 21925682261486377. Sep 07, 2026. Epub Sep 07, 2026.

Abstract

Study DesignProspective international multicenter observational cohort study.ObjectiveTo evaluate the relationships among distal radius and ulna (DRU) classification, growth velocity, and scoliosis progression patterns in adolescent idiopathic scoliosis (AIS) using longitudinal interval-based analyses in a multinational Asian cohort.MethodsPatients aged 10-18 years with AIS were prospectively enrolled from multiple Asian centers. DRU classification, Sanders classification, Risser stage, standing height, and Cobb angle were assessed at approximately 4-6-month intervals. Only observations obtained before brace treatment or surgery were included. Height velocity and Cobb progression velocity were calculated between consecutive visits. Stage-specific patterns were evaluated using boxplots, nonparametric analyses, and mixed-effects models adjusted for age, sex, and baseline Cobb angle.ResultsAmong 329 enrolled patients, 236 patients contributing 618 longitudinal intervals met eligibility criteria. Mean age was 13.5 years, and mean baseline Cobb angle was 24.0°. Height velocity peaked at Radius stage 6 (0.62 cm/month) and Ulnar stage 5 (0.68 cm/month). Cobb progression velocity was greatest at Radius stage 6 (0.31°/month); among adequately represented Ulnar stages, progression velocity was greatest at stage 5 (0.27°/month). Spearman analyses showed only very weak correlations between skeletal maturity stage and Cobb progression velocity. Mixed-effects analyses suggested nonlinear progression patterns, with increased progression velocity at earlier to intermediate maturity stages.ConclusionsDRU classification demonstrated stage-dependent progression patterns, with peak scoliosis progression generally occurring approximately one DRU stage after peak height velocity. These findings suggest that DRU classification may help identify skeletal maturity phases associated with accelerated scoliosis progression in AIS.

PMID:
42704710
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.