青少年特发性脊柱侧弯研究国外进展

Adolescent idiopathic scoliosis research progress in abroad

青少年特发性脊柱侧弯(adolescent idiopathic scoliosis,AIS)还有很多争论和未解决的问题,最困难的问题是病理发病机制不清楚。尽管支具治疗已经作为有曲线进展危险的侧弯患者标准的治疗方法,无论在功效和作用方面还不能经历严格的评价。随着对手术治疗的重视,技术大大改进,增加了手术安全性,保持脊柱的平衡,但是这些治疗方法长期的效果还不得知;外科手术可以减少畸形,防止曲线进一步进展,因此可以减少将来心肺功能出问题的危险,但是长期防止脊柱侧弯的其他负面作用还不清楚。本文讨论一下目前关于青少年特发性脊柱侧弯病理发病机制,自然病史,非手术治疗和手术治疗概念。

Many controversies and unanswered questions surround AIS （adolescent idiopathic scoliosis） , the most difficult one is the absence of information about its aetiopathogenesis. Although bracing has been regarded as the standard of care for patients at a high risk of progression, it has never been subjected to rigorous assessment of either its efficacy or effectiveness. With respect to surgical management, although technology has greatly increased the safety with which we can correct spinal deformity and preserve spinal balance, long - term results of these changing methods of management are absent. Surgery can reduce deformity and prevent further progression; thereby decreasing the risk of future cardiopulmonary compromise, but its role in the prevention of other negative long - term effects of scoliosis is not clear. In this paper we discuss present notions about aetiopathogenesis, natural history, non - operative treatment, and surgery.