成人退行性脊柱侧凸分型的研究进展

Research progress on the classification of adult degenerative scoliosis

成人脊柱侧凸是指骨骼发育成熟的患者伴有Cobb’s角〉10°的脊柱畸形。成人脊柱侧凸是一个广义的概念,包括所有原因引起的脊柱畸形,根据Aebi分型,可在病因学角度将成人脊柱侧凸分为4型（表1）。

Adult degenerative scoliosis（ ADS） is defined as a ＂De Novo＂ spinal deformity caused by asymmetry degeneration of the intervertebral disc and facet joint in a skeletally mature patient with a Cobb＇s angle more than 10° in the coronal plain. Other than adolescent idiopathic scoliosis, which has an internationally accepted and unified classification system, there are many studies on the causes and surgical methods of ADS. However, there is no widely accepted classification standard currently. This article summarizes the ADS classification in a tabular format. It clearly and accurately describes and analyzes the characteristics of different types, clinical applications, limitations, and potential guidelines for surgical planning. The current classification could not fully reflect the characteristics of the disease, and it does not have strong effects on the guidance of the treatment and the choice of the surgical plan. Therefore, we propose that the ideal classification system should reflect the deformity of the scoliosis in the threedimensional plane more systematically, as well as combine the clinical features and the patient＇s quality of life score, so as to determine the surgical method and the choice of fusion range. The classification will facilitate the disease system, define the natural course and therapeutic effects, combine the severity of the malformation with the patient＇s symptoms, and provide guidance for the choice of treatment methods.