This is also the stage that funnels patients towards spinal-fusion surgery as their condition approaches a surgical-level curve at 45 – 60 degrees. Secondary sexual characteristics are determined by the Tanner criteria for breast development and pubic hair development.
Stage 3 for breast and pubic hair occurs at or after the PHV and stage 4 occurrs after PHV.
Tanner staging scoliosis. Physically immature girls with idiopathic scoliosis were evaluated every six months through their growth spurt with serial spinal radiographs. Closure of the triradiate cartilage of the acetabulum and ossifying centers in. Up to the onset of puberty.
Idiopathic scoliosis is a growing spine disorder. Scoliosis Research Society SRS criteria recommend bracing for patients with AIS when they have curves between 25 and 40 are 10 years old or more are in Risser stages 0 1 or 2 and are premenarchal or less than 1 year after menarche. As the final stage of puberty has been observed to occur on or after Risser 2 11 lets look at this further breaking down risk by Risser scale.
Tanner stage 2 to 3 occurs just after the onset of the pubertal growth spurt and is the time of maximum progression of scoliosis6 The Risser grade. Determination of the Tanner stage is performed by a trained female observer. Menarche occurs in the declining phase of the growing peak and indicates a low risk of progression for curves under 30 in idiopathic scoliosis.
With severe scoliosis the two earlier responses of watching and waiting or using a Boston brace to stop progression would be continued. Adolescent Idiopathic Scoliosis is a coronal plane spinal deformity which most commonly presents in adolescent girls from ages 10 to 18. In the decelerating growth phase a Risser less than 1 is associated with progression in 60 to 70 of patients whereas Risser 3 has a risk for progression in less than 10.
At beginning of the adolescent growth spurt. Measurements should be repeated and carefully recorded at regular intervals. Furthermore patients are asked for self evaluation of the secondary sexual characteristics according to a figure of the Tanner stages.
The Sanders Skeletal Maturity Staging System has been used to predict curve progression in idiopathic scoliosis. The greater the risk the scoliosis will progress. In general the onset of the adolescent growth spurt occurs at 13 years in boys and 11 years in girls before and after reaching Tanner stage two.
The Tanner staging for secondary sexual characteristics development was reported to have close relationship to peak height with the majority of females exhibiting budding of the breast approximately one year before peak growth. And serologic studies of the levels of selected growth factors estradiol bone-specific alkaline phosphatase and osteocalcin. Clinical examples of use include delivering timely anticipatory guidance on menstrual hygiene needs menarche occurs about 2 years post-thelarcheTanner 2 breasts or targeting scoliosis exams at well-visits before and during peak height velocity Tanner 2 to 3 depending on sex 2.
We retrospectively reviewed 1100 consecutive patients with idiopathic scoliosis between 2005 and 2011. The low-value Risser sign the early Tanner stage and menarche indicate the progression of scoliosis 57. Diagnosis is made with full-length standing PA and lateral spine radiographs.
A Simplified Classification During Adolescence Both the Tanner-Whitehouse-III RUS score which is based on the radiographic. Tanner Staging rather than chronological age should be used in assessing pubertal development. Tanner stage 1 for breast strongly indicates pre-PHV.
Risser 0 at the time a scoliosis curve is observed. Tanner scale is a well-accepted rating system to assess maturity. Request PDF Predicting Scoliosis Progression from Skeletal Maturity.
Variations in pattern of pubertal changes in girls. Tanner stages for breast developmentStage I Preadolescent – Only the papilla is elevated above the level of the chest wallStage II – Breast Budding – Elevation of the breasts and papillae may occur as small mounds along with some increased diameter of the areolaeStage III – The breasts and areolae continue to enlarge although they show no separation of contourStage IV – The areolae and. This study intended to validate that initial study with a larger sample size.
In spinal disorders it is used to assess sceletal maturity thus growth potential. Only a perfect knowledge of normal growth parameters such as bone age stages of puberty standing and sitting height arm spam Tanner stages and weight allow the surgeon to plan the best treatment at the right moment. So it is important in adolescent idiopathic scoliosis.