Diard F, Chateil J F, Hauger O, Moinard M, Ducou-Lepointe H
Service de Radiologie A, Hôpital Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France.
J Radiol. 2002 Sep;83(9 Pt 2):1117-39; discussion 1141-2.
Scoliosis is frequent, especially during the peripubertal period, which corresponds to the period of greatest activity. About 75% of scoliosis are idiopathic, while the remaining 25% can be divided into neuromuscular, congenital and miscellaneous etiologies. When it is associated with pain, a comprehensive work up should be undertaken to identify the underlying etiology of the scoliosis. Idiopathic scoliosis is typically evaluated using standard radiographs. The number of follow-up radiographs and radiation exposure must be maintained to a minimum. Radiation safety guidelines and protocols must be implemented. Large cassettes can be replaced by digital acquisitions using units with reconstruction software. The technique of evaluation of these scoliosis series radiographs as well as their results will be reviewed. Recent data regarding the evaluation of spinal and pelvic balance parameters in the standing position will be introduced. Atypical idiopathic and other scoliosis require additional evaluation. Computed tomography, with 2D and 3D reformations, is ideal for evaluation of bony anomalies. MRI is ideal for evaluation of the spinal canal and cord, from the skull base down to the sacrum, for all patients with surgical scoliosis or patients with neurological symptoms. The increased availability of MR imaging has resulted in an increased number of so-called idiopathic asymptomatic scoliosis where an underlying anomaly can be identified.
脊柱侧弯很常见,尤其是在青春期前后,这一时期活动最为频繁。约75%的脊柱侧弯为特发性,其余25%可分为神经肌肉型、先天性及其他病因。当脊柱侧弯伴有疼痛时,应进行全面检查以确定其潜在病因。特发性脊柱侧弯通常采用标准X线片进行评估。随访X线片的数量及辐射暴露必须降至最低。必须执行辐射安全指南和规程。大尺寸暗盒可被使用具备重建软件的设备进行的数字采集所取代。将对这些脊柱侧弯系列X线片的评估技术及其结果进行回顾。还将介绍有关站立位脊柱和骨盆平衡参数评估的最新数据。非典型特发性脊柱侧弯及其他脊柱侧弯需要进一步评估。具有二维和三维重建功能的计算机断层扫描对于评估骨骼异常非常理想。对于所有接受脊柱侧弯手术的患者或有神经症状的患者,磁共振成像对于评估从颅底到骶骨的椎管和脊髓非常理想。磁共振成像可用性的提高导致所谓的特发性无症状脊柱侧弯病例增多,其中可以发现潜在异常。