Medical Health Encyclopedia

Three-Dimensional Modeling Techniques. Advanced computer modeling techniques are able to create three dimensional images using x-rays or other two-dimensional images. They allow physicians to observe the spinal distortions and eventually could reduce the number of x-rays currently needed to monitor scoliosis and help surgeons determine optimal surgical procedures.

Determining the End of Growth

Even if the curve is accurately calculated, it still remains difficult to predict whether the scoliosis will progress. A recent report indicates that measuring the nerve conduction activity of the muscles supporting the spine may help predict subsequent progression in children with scoliosis. In addition, computer models are being used to better predict risk. One approach requires the measurement of 21 radiographic and clinical indicators and that are entered into a computer program. The technique takes less than 20 minutes per patient and was found to be up to 80% accurate in determining progression of curvature.

One way of predicting whether or not the curvature will progress is knowing when the child will stop growing:

• If the child has years to grow, then the spine has more time to progress.
• If the child will stop growing within a year, then progression should be very slight. (It should be noted, however, that some progression continues in nearly 70% of curves even after the spine has matured.)
• Knowing the child's age is, of course, the first step in estimating the end of growth. In addition, other methods have been developed to help predict the end of the growth stage.

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One method is called the Risser sign, which grades the amount of bone in the area at the top of the hipbone. A low grade indicates that the skeleton still has considerable growth; a high grade means that the child has nearly stopped growing and the curve is unlikely to progress much further. The Risser scale differs between genders, and in boys, a high grade does not always signify the end of progression.