• Yusuke Hori, Burak Kaymaz, Luiz C Almeida da Silva, Kenneth J Rogers, Petya Yorgova, Peter G Gabos, and Suken A Shah.
• Department of Orthopaedic Surgery, Nemours Children's Health, Wilmington, DE.
• Spine. 2024 Jul 1; 49 (13): 902908902-908.

Study DesignA single-center retrospective case-control study.ObjectiveTo compare the spine and total height velocity between Sanders maturation stage (SMS) 3A and 3B.Summary Of Background DataIdentifying SMS 3 is critical for treating growing children because it represents the early phase of rapid adolescent growth. However, there is limited literature available that clearly describes the growth differences between 3A and 3B.Materials And MethodsThe current study included consecutive patients with idiopathic scoliosis staged SMS 3 from January 2012 to December 2021. T1-S1 spine height, total body height, and curve magnitude were measured at the initial and follow-up visits. In addition to the spine and total height velocity calculated per month, corrected height velocity was estimated for curve magnitude using a validated formula. Mann-Whitney U test was used to compare SMS 3A and 3B outcomes, followed by a multiple linear regression model to evaluate the association of the SMS subclassifications to growth velocity adjusted for confounding factors.ResultsA total of 204 patients (66% girls, mean age: 12.3±1.3 y) met the inclusion criteria. Patients staged SMS 3A had higher spine height velocity (mm/month) in both girls (2.3 vs. 1.5, P <0.001) and boys (2.6 vs. 1.7, P <0.001), as well as total height velocity [mm/month; (5.8 vs. 4.3, P <0.001 for girls; 6.6 vs. 4.5, P <0.001 for boys]. Corrected velocity showed similar results with greater spine and total height velocity in SMS 3A. Multivariate analysis indicated a significant association of the SMS subclassification to the spine and total height velocity. The scoliosis curve progression was comparable between SMS 3A and 3B.ConclusionsSMS 3A and 3B had differential growth velocity in the spine and total body height. These results indicate the importance of the SMS 3 subclassification for managing scoliosis treatment, including observation, bracing, and surgical interventions with fusion and growth modulation.Level Of EvidenceLevel III-case-control study.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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