青少年特发性脊柱侧凸支具和保守治疗研究进展

Research Progress of Brace and Conservative Treatment of Adolescent Idiopathic Scoliosis

青少年特发性脊柱侧凸(AIS)是一种包括冠状面上的侧弯、矢状面上的失平衡和椎体在横轴位上旋转在内的三维畸形。曲线的发展主要与青春期前后的快速生长有关。自然病史的发展可能会导致脊柱和胸部畸形,严重情况下需要进行手术治疗。在青春期,通过非手术治疗的方法可能会延缓曲线进程,甚至减小曲度。我们描述了世界各地使用的不同类型的支架,它们的适应症、技术要点和治疗效果。文献一致认为,在适应症下,对于Cobb角在20˚~45˚这一区间仍在增长的患者,一个设计良好并且适配的支具可以在大多数情况下阻止曲度的进展。

Adolescent idiopathic scoliosis (AIS) represents the most frequent tridimensional spinal deformity. Progression of curves is linked mainly to the rapid growth around puberty. The natural history can lead to large spinal and thoracic deformities, which could impose surgical treatments. In that specific adolescent period, it is possible with very accurate treatments to alt curves progression. We describe the different types of braces used worldwide, their indications, technical applications, results and failures, as well as our own experience. There is a consensus in the literature that, for indications, a well-designed and adapted support can prevent progression of curvature in most cases in patients whose Cobb angle is increasing between 20˚ and 45˚.