Sponseller Paul D, Yazici Muharrem, Demetracopoulos Constantine, Emans John B
Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Spine (Phila Pa 1976). 2007 Sep 1;32(19 Suppl):S81-90. doi: 10.1097/BRS.0b013e3181453073.
: Review of relevant studies, including levels of evidence.
: To review research on growth of the spine and chest wall and treatment of deformities. To place this knowledge in context of evidence-based assessment.
: Knowledge of the growth of the spine, chest wall, and lung in the normal and deformity states has evolved among independent specialties over the past 60 years. Interest in the interrelationship has blossomed as more tools for assessment and treatment have developed. Spine-based and chest wall-based treatment options now exist, as well as options of resection versus gradual distraction.
: Peer-reviewed research published on the growth of the spine, lung, chest wall, and treatment of their deformities was reviewed. Treatment methods and outcomes were compared. Ranking of the levels of evidence was performed where possible.
: Most studies of these topics are Level III and IV studies, consisting of case-control studies and case series. This limitation arises because of the rarity and heterogeneity of the disorders affecting the growing spine and chest wall. The natural history of most types of spinal/chest wall deformities is not known with accuracy. Some experimental evidence informs the treatments which involve modulation of the growth of the spine. However, accurate models of the deformities themselves are lacking. Improvements in imaging and measurement offer options for more accurate patient comparison.
: The natural history and results of treatment of deformities of the spine and chest wall offer much opportunity for further evidence-based research.
对相关研究进行综述，包括证据水平。
综述脊柱和胸壁生长及畸形治疗的研究。将这些知识置于循证评估的背景下。
在过去60年中，脊柱、胸壁和肺部在正常及畸形状态下生长的知识在不同的独立专业领域不断发展。随着更多评估和治疗工具的开发，对它们之间相互关系的兴趣日益浓厚。现在有基于脊柱和基于胸壁的治疗选择，以及切除与逐步牵引的选择。
对已发表的关于脊柱、肺部、胸壁生长及其畸形治疗的同行评审研究进行综述。比较治疗方法和结果。尽可能对证据水平进行排名。
这些主题的大多数研究是III级和IV级研究，包括病例对照研究和病例系列。由于影响生长中的脊柱和胸壁的疾病罕见且异质性大，所以存在这一局限性。大多数类型的脊柱/胸壁畸形的自然病史尚不准确。一些实验证据为涉及调节脊柱生长的治疗提供了依据。然而，缺乏畸形本身的精确模型。成像和测量的改进为更准确地比较患者提供了选择。
脊柱和胸壁畸形的自然病史及治疗结果为进一步的循证研究提供了很多机会。
