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DOES RACE INFLUENCE THE PROGRESSION OF ADOLESCENT IDIOPATHIC SCOLIOSIS?

Scoliosis Clinic, Institute of Orthopaedics and Traumatology, Hospital Kuala Lumpur, Malaysia

Introduction: Understanding the factors in progression of curves in spinal deformities are crucial to the planning of treatment. While clinical and genetic parameters appear to be involved in the progression of adolescent idiopathic scoliosis, it remains very difficult to objectively study this as it is difficult to find pedigree cohorts. We wish to report the difference in progression of adolescent idiopathic scoliosis curves in two essentially homogenous racial groups that utilise our Scoliosis service.

Methods and Results: Three hundred and twenty-four patients were treated at the Scoliosis service of our Institute from 1985 to 1998. The aetiology of the curves were as follows: 218 AIS, 37 Neuromuscular, 48 Congenital, 21 other diagnostic type, and 11 aetiology not known. The racial distribution of utilisation of service: 44% Malay, 44.7% Chinese, 2.0% Indian and 9.3% not known or mixed race. The Malay and Chines groups were matched and studied. There was no difference in the menarchal age, curve size at presentation and age at presentation to the service (P=0.3). Patients were analysed in two groups: below 10 years, and above 10 years at presentation.

The rate of progress of the AIS curves > 50° were fastest in the Chinese patients with a rate of 14.7°/year; with Malay patients progressing at 8.4°/year. Rates of progression of curves 30–50° were the same for both groups with Chinese at 7.7°/year, and Malays at 6.7°/year. Curves < 30° progressed at the same rate also with Chinese at 5.0°/year and Malays at 7.0°/year.

Conclusion: From our data, it appears that race (genetics) does influence the rate of progression of AIS curves.

Abstracts prepared by Mr J. Dorgan. Correspondence should be addressed to him at the Royal Liverpool Children’s Hospital, Alder Hey, Eaton Road, Liverpool L12 2AP, UK

President’s Lecture: Natural history and management of Congenital Kyphosis and Kyphoscoliosis M.J. McMaster, Edinburgh, Scotland, UK

Greg Houghton Lecture: Idiopathic Scoliosis – Alternatives to traditional surgery R.R. Betz, Philadelphia, USA

Instructional Lecture:New thoughts on the treatment of paralytic scoliosis R.R. Betz, Philadelphia, USA

Keynote Lectures: Idiopathic Scoliosis – How to manage the patient R.A. Dickson, Leeds, UK

Concave or convex approach for Kyphoscoliosis J. Dubousset, Paris, France Surgery or bracing for moderate AIS. How long term follow-up studies change your perspective A. Nachemson, Göteborg, Sweden