Histologic, Risser sign, and digital skeletal age evaluation for residual spine growth potential in Chinese female idiopathic scoliosis

Study Design. A prospective study. Objective. To ascertain the correlation between histologic grades (HGs) of vertebral growth plates and Risser grades as well as DSA stages in the Chinese female idiopathic scoliosis (IS) patients; to identify whether digital skeletal age (DSA) is a reliable indicator for accurate evaluation of the spinal residual growth potential. Summary of Background Data. DSA is considered one of the more important indicators for representing the peak height velocity (PHV) typically and predicting spinal growth potential. The correlation between HGs of growth plates and DSA stages in IS patients is unclear. Methods. Thirty-nine Chinese female patients were available for this study. Superior and inferior growth plates were obtained at each level when anterior approach surgeries were performed. Histologic examinations were conducted after the specimens were processed. Of these patients, 28 cases were evaluated by DSA stages in this study. Correlations between histologic grades, Risser grades, menarchal status, and chronologic age were analyzed in 39 patients. Correlations between histologic grades, DSA, menarchal status, and chronologic age were analyzed in 28 patients. Results. There was a negative correlation between the following: HGs and Risser grades in 39 patients (r = - 0.645, P = 0.000-0.05), HGs and menarchal status in patients in Risser 4 (r = - 0.710, P = 0.002-0.05), HGs and DSA stages in 28 cases (r = -0.541, P = 0.003-0.05), and HGs and menarchal status in patients in DSA Stage III (r = -0.591, P = 0.006-0.05). Statistical significance of growth activity of growth plates was found between patients in Risser Grades 0 to 1 and those in Risser Grades 2 to 5 (P = 0.020-0.05) and patients in DSA Stage II and those in DSA Stage III (P = 0.014-0.05). Conclusion. DSA may be a reliable indicator for predicting the spinal residual growth potential in IS patients, but it should be correlated with menarchal status and chronologic ages.