Menarche in scoliotic and nonscoliotic Mediterranean girls. Is there any relation between menarche and laterality of scoliotic curves?

Unlabelled: There is a controversy in the current literature concerning the age at menarche between scoliotic and nonscoliotic girls. The aim of this study is to elucidate this issue in the Mediterranean school aged girls.

Material And Methods: The menarche of 1,305 nonscoliotic girls (mean age 12,3 years, range 7,41 to 18,41 years, SD 2,5 years) and of 105 scoliotic girls (mean age 14.15 years, range 7.47 to 18.97 years, SD=2.7 years) was studied. These two groups originate from a total population of 4,535 schoolchildren who were examined during school screening (2,245 girls, 2,290 boys). The Angle of Trunk Inclination (ATI) greater or equal to 7 degrees, measured with the Pruijis Scoliometer was used as a pass-fail criterion for radiological examination. The diagnosis of scoliosis was defined as the finding of a Cobb angle greater or equal to 10 degrees on a standing postero-anterior radiograph of the spine. Statistical analysis was performed using the SPSS statistical program.

Results: 476 girls out of 1,305 nonscoliotic girls (36,50%, mean age 14,04 years, range 9.04 to 18,21 years, SD=1.59 years) had menarche (mean age at menarche 12,07 years, SD 1,35 years, range from 7,63 to 14,59 years), while the remaining 829 girls (63,50%, mean age 11,09 years, SD 2,09 years, range 7,41 to 18,47 years) had not any. On the other hand, 77 out of the 105 scoliotic girls had menarche (73,33%, mean age 15,29 years, SD 1,54 years, range 11,35 to 18,97 years). The mean age at menarche of the scoliotic girls was 11,98 years, SD 1,49 years, range 7,7 to 16,72 years. Twenty-eight scoliotic girls had no menarche yet (mean age 10.99 years, range 7.41 to 17.24 years, SD=2.72). There was a predominance of right-sided primary curves in menarche positive scoliotic girls (61%), while menarche negative scoliotic girls showed mainly left sided primary curves (64,3%). This difference is statistically significant (p<0,05). The frequency of the various scoliotic curves in menarche positive scoliotic girls was as follows: right thoracic (32,5%), left lumbar (23,4%) and right thoracolumbar (15,6%) curves. The respective locations of scoliotic curves in girls without menarche were left lumbar (25%), left thoracolumbar (25%) and thoracic curves (14,3%) were equally distributed on both. Delayed onset of menarche or no menarche was observed in 4 scoliotic girls. Furthermore, 2 scoliotic girls mentioned that they had menarche after the age of 15 years and only after hormonal treatment. Despite of the apparent prevalence of the scoliotic girls in the menarche positive population, there is no statistically significant difference between scoliotic and nonscoliotic girls with menarche when the respective ages at menarche are compared.

Conclusion: In this study, there was not a statistically significant difference of the age at menarche between scoliotic and nonscoliotic girls. On the other hand, there was a significant difference between menarche positive and menarche negative scoliotic girls in relation to the laterality of scoliotic curves: the former showed predominantly right sided primary curves while the latter had mainly left sided primary curves.