Greiner K Allen
Department of Family Medicine, University of Kansas Medical Center, Kansas City 66160-7370, USA.
Am Fam Physician. 2002 May 1;65(9):1817-22.
Adolescent onset of severe idiopathic scoliosis has traditionally been evaluated using standing posteroanterior radiographs of the full spine to assess lateral curvature with the Cobb method. The most tilted vertebral bodies above and below the apex of the spinal curve are used to create intersecting lines that give the curve degree. This definition is controversial, and patients do not exhibit clinically significant respiratory symptoms with idiopathic scoliosis until their curves are 60 to 100 degrees. There is no difference in the prevalence of back pain or mortality between patients with untreated adolescent idiopathic scoliosis and the general population. Therefore, many patients referred to physicians for evaluation of scoliosis do not need radiographic evaluation, back examinations, or treatment. Consensus recommendations for population screening, evaluation, and treatment of this disorder by medical organizations vary widely. Recent studies cast doubt on the clinical value of school-based screening programs.
重度特发性脊柱侧凸的青少年发病情况传统上是通过全脊柱站立后前位X线片进行评估的，以采用Cobb法评估侧方弯曲。脊柱曲线顶点上方和下方最倾斜的椎体用于绘制相交线，从而得出曲线度数。这一定义存在争议，而且特发性脊柱侧凸患者在其曲线达到60至100度之前不会出现具有临床意义的呼吸症状。未经治疗的青少年特发性脊柱侧凸患者与普通人群相比，背痛患病率或死亡率并无差异。因此，许多因脊柱侧凸转诊至医生处进行评估的患者并不需要进行X线评估、背部检查或治疗。各医学组织针对该疾病的人群筛查、评估和治疗的共识性建议差异很大。近期研究对基于学校的筛查项目的临床价值提出了质疑。
