Avellanet M, González Viejo M-A, Sáenz A, Hijós M-E
Service de médecine physique et réadaptation, hôpital Nostra-Sra, Meritxell, Avda Fiter i Rossell 1-13, AD700 Escaldes-Engordany, Principauté d'Andorre, Spain.
Ann Readapt Med Phys. 2006 Dec;49(9):659-62. doi: 10.1016/j.annrmp.2006.05.005. Epub 2006 Jun 23.
Orthopaedic treatment for idiopathic scoliosis in adolescence is indicated with a curve of > or =20 degrees and a Risser score< or =4, because progression of curve is low with Risser scores >4. We present the case of a young man with a left lumbar idiopathic scoliosis (T12-L4) with a curve of 10 degrees, which was stable from 13 years (Risser 0) to 16 years old (Risser 4). The scoliosis progressed quickly after a Risser score of 4 was achieved. The man had been wearing a lift on the left foot since he was 13, because of a leg length discrepancy, and had been under clinical and radiological monitoring. When the boy reached 17 years, the scoliosis rapidly progressed, to a curve of 22 degrees and a Risser score of >4. The scoliosis was effectively treated with a Boston brace. At 20 years, the Risser score was 5, and the left lumbar curve was 13 degrees after discontinuing the use of the brace. To our knowledge, no scientific reference indicates a time limit to orthopaedic treatment for idiopathic adolescent scoliosis. Despite the experts' recommendations, a brace might be indicated with a Risser score > or =4 to stop the progression of the curve.
对于青少年特发性脊柱侧凸，当侧弯角度≥20度且Risser评分≤4时，建议进行骨科治疗，因为Risser评分>4时侧弯进展缓慢。我们报告一例患有左侧腰椎特发性脊柱侧凸（T12-L4）的年轻男性病例，其侧弯角度为10度，从13岁（Risser 0）到16岁（Risser 4）病情稳定。在Risser评分为4之后，脊柱侧凸迅速进展。该男性自13岁起因腿长差异一直穿着左脚鞋垫，并接受临床和影像学监测。当该男孩17岁时，脊柱侧凸迅速进展至22度且Risser评分>4。使用波士顿支具对脊柱侧凸进行了有效治疗。20岁时，Risser评分为5，停用支具后左侧腰椎侧弯为13度。据我们所知，没有科学参考文献表明青少年特发性脊柱侧凸骨科治疗的时间限制。尽管有专家建议，但对于Risser评分≥4的情况，可能仍需使用支具以阻止侧弯进展。
