How is the Sanders Score (Scoliosis Growth Prediction) used to predict growth, and what do the numbered hand stages correspond to in terms of skeletal maturity?

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Last updated: April 24, 2025View editorial policy

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From the Research

The Sanders Score is a method used to predict growth potential in patients with scoliosis by assessing skeletal maturity through hand radiographs, dividing hand development into eight stages (1-8) that correspond to specific growth milestones. The Sanders Score is used to predict growth potential in patients with scoliosis by assessing skeletal maturity through hand radiographs, as seen in studies such as 1 and 2.

Key Stages of the Sanders Score

The eight stages of the Sanders Score are:

  • Stage 1: significant growth remaining, with all digits showing open physes
  • Stages 2-3: rapid growth, with stage 2 showing capping of the middle phalanges and stage 3 showing capping of proximal phalanges
  • Stage 4: growth peak, with fusion of some middle phalanges
  • Stages 5-6: deceleration of growth with progressive fusion of phalanges
  • Stages 7-8: minimal growth remaining, with stage 7 showing fusion of distal radius and stage 8 showing complete fusion of all physes These stages help surgeons determine optimal timing for scoliosis interventions, such as bracing during stages 2-4 when growth is rapid, as noted in 3.

Clinical Application

The system is valuable because it correlates hand development with spine growth potential, allowing for more personalized treatment planning, as discussed in 4. Some of the key points to consider when using the Sanders Score include:

  • The correlation between the Risser stage and the Sanders Maturity Scale (SMS) stage, as seen in 3
  • The use of the Sanders Skeletal Maturity System (SSMS) in regard to precision and accuracy, as evaluated in 4
  • The importance of accurate assessment of skeletal maturity in adolescent idiopathic scoliosis (AIS) patients for selection and timing of optimal treatment, as noted in 1 and 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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