Reamy B V, Slakey J B
Malcolm Grow Medical Center, Andrews Air Force Base, Maryland, USA.
Am Fam Physician. 2001 Jul 1;64(1):111-6.
Adolescent idiopathic scoliosis is present in 2 to 4 percent of children between 10 and 16 years of age. It is defined as a lateral curvature of the spine greater than 10 degrees accompanied by vertebral rotation. It is thought to be a multigene dominant condition with variable phenotypic expression. Scoliosis can be identified by the Adam's forward bend test during physical examination. Severe pain, a left thoracic curve or an abnormal neurologic examination are red flags that point to a secondary cause for spinal deformity. Specialty consultation and magnetic resonance imaging are needed if red flags are present. Of adolescents diagnosed with scoliosis, only 10 percent have curves that progress and require medical intervention. The main risk factors for curve progression are a large curve magnitude, skeletal immaturity and female gender. The likelihood of curve progression can be estimated by measuring the curve magnitude using the Cobb method on radiographs and by assessing skeletal growth potential using Tanner staging and Risser grading.
青少年特发性脊柱侧凸在10至16岁的儿童中发病率为2%至4%。它被定义为脊柱侧弯大于10度并伴有椎体旋转。它被认为是一种具有可变表型表达的多基因显性疾病。脊柱侧凸可通过体检时的亚当前屈试验来识别。严重疼痛、左胸弯或神经系统检查异常是提示脊柱畸形继发原因的警示信号。如果出现警示信号，则需要专科会诊和磁共振成像检查。在被诊断为脊柱侧凸的青少年中，只有10%的人侧弯会进展并需要医学干预。侧弯进展的主要危险因素是侧弯角度大、骨骼未成熟和女性性别。侧弯进展的可能性可以通过在X线片上使用Cobb法测量侧弯角度以及通过使用坦纳分期和里塞尔分级评估骨骼生长潜力来估计。
