ABSTRACT: Study design. Retrospective radiographic study.Objective. To compare the gender differences in curve patterns and radiographic characteristics in patients who have adolescent idiopathic scoliosis (AIS).
Summary of Background Data. Gender differences in AIS have been documented in the incidence of curve progression, response to bracing, and outcomes of surgical treatment. However, limited information is available about the relation between sex and scoliosis curve patterns and radiographic presentations.
Methods. 359 male and 999 female AIS patients with major curve ≥ 20º were recruited. Standard posteroanterior and lateral radiographs of spine were reviewed to classify scoliosis curve patterns as typical or atypical, and to measure curve severity and thoracic kyphosis. In 351 surgically treated patients, side-bending films were used to assess curve flexibility. Comparisons between male and female patients were made by subgrouping patients according to curve patterns and severity.
Results. Atypical curves were more frequently observed in male (19.8%) than in female gender (8.9%) (p < 0.01). Gender differences were also found in the distribution of curve types. Main thoracic curve was the most common curve type in both genders. Furthermore, significantly higher incidence of main thoracic curve in severe AIS than moderate patients was found in male (p < 0.001) but not in female gender. In patients with severe AIS who had typical curve patterns that included a major thoracic curve, male patients had larger magnitude of thoracic curve, more severe thoracic kyphosis, and more rigid thoracic and lumbar curves than female patients.
Conclusions. Atypical curve patterns were more predominantly in male than female AIS. The thoracic curve in male AIS patients might have higher incidence of progression than female gender. The higher rigidity of both thoracic and lumbar curves in male AIS with severe curves might contribute to the lower curve correction rate and poor response to brace when compared to female cases.
Source: PubMed Central