Tribus Clifford B
Clinical Science Center, University of Wisconsin-Madison, USA.
J Am Acad Orthop Surg. 2003 May-Jun;11(3):174-83. doi: 10.5435/00124635-200305000-00004.
Degenerative lumbar scoliosis is a lateral deviation of the spine that typically develops after age 50 years. Clinical presentation varies, but the deformity frequently is associated with loss of lordosis, axial rotation, lateral listhesis, and spondylolisthesis. Although the etiology is unclear, degenerative scoliosis is associated with degenerative disk disease, facet incompetence, and hypertrophy of the ligamenta flava, typically leading to neurogenic claudication and back pain. Rarely, sagittal or coronal imbalance may develop. Indications for treatment include pain, progressive deformity, radiculopathy or myelopathy, and cosmetic deformity. Nonsurgical care focuses on patient education, exercise, and nonnarcotic medication. Surgical management should be considered carefully, balancing the benefits and risks for the patient.
退行性腰椎侧弯是一种脊柱的侧方偏移，通常在50岁以后出现。临床表现各异，但这种畸形常与腰椎前凸消失、轴向旋转、侧方滑脱及椎体滑脱相关。尽管病因尚不清楚，但退行性侧弯与椎间盘退变、小关节功能不全及黄韧带肥厚有关，通常会导致神经源性间歇性跛行和背痛。很少会出现矢状面或冠状面失衡。治疗指征包括疼痛、进行性畸形、神经根病或脊髓病以及外观畸形。非手术治疗侧重于患者教育、锻炼和非麻醉性药物。应仔细考虑手术治疗，权衡对患者的利弊。
