Parent Stefan, Newton Peter O, Wenger Dennis R
Department of Pediatric Orthopedics, Children's Hospital at San Diego, California, USA.
Instr Course Lect. 2005;54:529-36.
Adolescent idiopathic scoliosis is a three-dimensional deformity of the spine. Despite active efforts by different research teams, the etiology of scoliosis remains unclear. Treatment of scoliosis requires a solid understanding of the natural history of the disorder as well as sound clinical judgment. The evaluation, monitoring, and institution of conservative treatment such as bracing can present a challenge to the orthopaedic surgeon. Clinical monitoring is the only intervention necessary in most patients. A detailed review of the patient's history as well as a careful physical examination can help establish the diagnosis and the risk for progression. Skeletal maturity, gender; growth velocity, curve location, and magnitude are factors that can help assess the likelihood of progression. Bracing is the only nonsurgical measure proven to have any effect on halting the progression of scoliosis. Other forms of conservative treatment have not been shown to significantly modify the natural history of idiopathic scoliosis. Bracing results are directly related to compliance with brace treatment; therefore, optimal results cannot be achieved without the patient's cooperation and family support.
青少年特发性脊柱侧凸是一种脊柱的三维畸形。尽管不同的研究团队积极努力，但脊柱侧凸的病因仍不清楚。脊柱侧凸的治疗需要对该疾病的自然史有扎实的了解以及合理的临床判断。对脊柱侧凸进行评估、监测并实施诸如支具治疗等保守治疗，可能会给骨科医生带来挑战。在大多数患者中，临床监测是唯一必要的干预措施。对患者病史进行详细回顾以及仔细的体格检查有助于确立诊断和病情进展风险。骨骼成熟度、性别、生长速度、侧弯位置和严重程度是有助于评估病情进展可能性的因素。支具是唯一被证明对阻止脊柱侧凸进展有作用的非手术措施。其他形式的保守治疗尚未显示能显著改变特发性脊柱侧凸的自然史。支具治疗的效果直接与支具治疗的依从性相关；因此，没有患者的配合和家庭支持就无法取得最佳效果。
