Development and Initial Validation of the Classification of Early-Onset Scoliosis (C-EOS)

被引：211

作者：

Williams, Brendan A. ^{[1
]}

Matsumoto, Hiroko ^{[1
]}

McCalla, Daren J. ^{[1
]}

Akbarnia, Behrooz A. ^{[1
]}

Blakemore, Laurel C. ^{[1
]}

Betz, Randal R. ^{[1
]}

Flynn, John M. ^{[1
]}

Johnston, Charles E. ^{[1
]}

McCarthy, Richard E. ^{[1
]}

Roye, David P., Jr. ^{[1
]}

Skaggs, David L. ^{[1
]}

Smith, John T. ^{[1
]}

Snyder, Brian D. ^{[1
]}

Sponseller, Paul D. ^{[1
]}

Sturm, Peter F. ^{[1
]}

Thompson, George H. ^{[1
]}

Yazici, Muharrem ^{[1
]}

Vitale, Michael G. ^{[1
]}

机构：

[1] Columbia Univ, Med Ctr, New York, NY 10032 USA

来源：

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME | 2014年 / 96A卷 / 16期

关键词：

IDIOPATHIC SCOLIOSIS; THORACIC KYPHOSIS; MULTIDIRECTIONAL INSTABILITY; PULMONARY-FUNCTION; PATIENT OUTCOMES; SPINAL DEFORMITY; CONTENT VALIDITY; CONSENSUS PANEL; FUSION; MANAGEMENT;

D O I：

10.2106/JBJS.M.00253

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: Early-onset scoliosis is a heterogeneous condition, with highly variable manifestations and natural history. No standardized classification system exists to describe and group patients, to guide optimal care, or to prognosticate outcomes within this population. A classification system for early-onset scoliosis is thus a necessary prerequisite to the timely evolution of care of these patients. Methods: Fifteen experienced surgeons participated in a nominal group technique designed to achieve a consensus-based classification system for early-onset scoliosis. A comprehensive list of factors important in managing early-onset scoliosis was generated using a standardized literature review, semi-structured interviews, and open forum discussion. Three group meetings and two rounds of surveying guided the selection of classification components, subgroupings, and cut-points. Initial validation of the system was conducted using an interobserver reliability assessment based on the classification of a series of thirty cases. Results: Nominal group technique was used to identify three core variables (major curve angle, etiology, and kyphosis) with high group content validity scores. Age and curve progression ranked slightly lower. Participants evaluated the cases of thirty patients with early-onset scoliosis for reliability testing. The mean kappa value for etiology (0.64) was substantial, while the mean kappa values for major curve angle (0.95) and kyphosis (0.93) indicated almost perfect agreement. The final classification consisted of a continuous age prefix, etiology (congenital or structural, neuromuscular, syndromic, and idiopathic), major curve angle (1, 2, 3, or 4), and kyphosis (-, N, or +) variables, and an optional progression modifier (P0, P1, or P2). Conclusions: Utilizing formal consensus-building methods in a large group of surgeons experienced in treating early-onset scoliosis, a novel classification system for early-onset scoliosis was developed with all core components demonstrating substantial to excellent interobserver reliability. This classification system will serve as a foundation to guide ongoing research efforts and standardize communication in the clinical setting.

引用

页码：1359 / 1367

页数：9

共 39 条

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