Determining the minimal clinically important difference of angle of trunk rotation for monitoring conservatively treated adolescent idiopathic scoliosis
EUROPEAN SPINE JOURNAL, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00586-026-10179-w
- Dergi Adı: EUROPEAN SPINE JOURNAL
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Dokuz Eylül Üniversitesi Adresli: Evet
Özet
Purpose The angle of trunk rotation (ATR) is widely used in the clinical follow-up of adolescent idiopathic scoliosis (AIS); however, the minimal clinically important difference (MCID) has not been clearly defined. This study aimed to determine treatment-specific MCID values for ATR in conservatively treated AIS patients. Methods This retrospective cohort study included 316 AIS patients treated with brace plus exercise or exercise alone. Radiographic outcomes at 6 months were classified as improvement (Delta Cobb <= - 5 degrees), stabilization (- 5 degrees < Delta Cobb < + 5 degrees), or worsening (Delta Cobb >= + 5 degrees). Receiver operating characteristic (ROC) analyses were performed to determine optimal Delta ATR cut-off values for clinically meaningful improvement and worsening in the overall cohort and separately by treatment group. Results In the overall cohort, Delta ATR showed good discriminative ability for improvement (AUC = 0.778) and worsening (AUC = 0.777). The optimal cut-offs were Delta ATR <= - 1.5 degrees for improvement and Delta ATR >= + 0.5 degrees for worsening. In subgroup analyses, the improvement threshold was Delta ATR <= - 1.5 degrees in the exercise-only group and <= - 4.5 degrees in the brace-plus-exercise group. For radiographic worsening, the optimal thresholds were Delta ATR >= + 0.5 degrees in the exercise-only group and >= - 2.5 degrees in the brace-plus-exercise group. Conclusions Treatment-specific Delta ATR thresholds provide clinically meaningful benchmarks for monitoring both improvement and worsening, supporting the use of ATR as a practical radiation-free follow-up parameter in AIS management.