A Novel Classification of Juvenile and Adolescent Idiopathic Scoliosis for Conservative Treatment

- BACKGROUND: The operative classification of scoliosis is well -developed but inadequate for guiding conservative treatment. The current conservative classification for juvenile and adolescent idiopathic scoliosis (JAIS) exhibits noticeable deficiencies. This study aimed to establish the Peking Union Medical College Hospital (PUMCH) classification and assess its clinical value in the conservative treatment of JAIS. - METHODS: This study consisted of 2 parts. First, it involved a retrospective analysis of patients treated for JAIS in the Department of Rehabilitation Medicine, the *** Union Medical College Hospital, between January 2013 and June 2020. Second, it involved an ambispective cohort study that enrolled patients with JAIS in the above hospital between July and December 2020. - RESULTS: A total of 989 patients with JAIS were enrolled, with 899 patients for establishing the PUMCH classification and 90 patients with JAIS for validating the PUMCH classification. The classification demonstrated an average reliability of 88.22% with a kappa coefficient of 0.862. After 1 week, the remeasured results presented a mean reproducibility of 92.78% and a kappa coefficient of 0.908. After 1 -year follow-up, the Cobb angle decreased significantly from 16.61 +/- 2.88 degrees to 12.16 degrees +/- 9.97 degrees (P = 0.002) in 51 patients with PUMCH-scoliosis-specific exercise (SSE) treatment, while the Cobb angle increased significantly from 15.74 +/- 2.75 degrees to 17.64 +/- 5.60 degrees ( P = 0.014) in 39 patients without PUMCH-SSE treatment. - CONCLUSIONS: The PUMCH-SSE classification demonstrates good inter -observer reliability and intra-observer reproducibility. In addition, the classification may be used to guide the conservative treatment of JAIS in clinical settings.