Wong Hee-Kit, Tan Ken-Jin
University Spine Center, University Orthopedics, Hand and Reconstructive Microsurgery Cluster, National University Health System, Singapore.
Indian J Orthop. 2010 Jan;44(1):9-13. doi: 10.4103/0019-5413.58601.
There have been great advances in the conservative and surgical treatment for adolescent idiopathic scoliosis in the last few decades. The challenge for the physician is the decision for the optimal time to institute therapy for the individual child. This makes an understanding of the natural history and risk factors for curve progression of significant importance. Reported rates of curve progression vary from 1.6% for skeletally mature children with a small curve magnitude to 68% for skeletally immature children with larger curve magnitudes. Although the patient's age at presentation, the Risser sign, the patient's menarchal status and the magnitude of the curve have been described as risk factors for curve progression, there is evidence that the absolute curve magnitude at presentation may be most predictive of progression in the long term. A curve magnitude of 25 degrees at presentation may be predictive of a greater risk of curve progression. Advances in research may unlock novel predictive factors, which are based on the underlying pathogenesis of this disorder.
在过去几十年里，青少年特发性脊柱侧凸的保守治疗和手术治疗都取得了巨大进展。医生面临的挑战是为每个孩子决定开始治疗的最佳时机。这使得了解其自然病史和侧弯进展的风险因素变得至关重要。报道的侧弯进展率从骨骼成熟、侧弯程度较小的儿童的1.6%到骨骼未成熟、侧弯程度较大的儿童的68%不等。虽然患者就诊时的年龄、Risser征、月经初潮状态和侧弯程度已被描述为侧弯进展的风险因素，但有证据表明，就诊时的绝对侧弯程度可能是长期进展的最有力预测指标。就诊时侧弯程度为25度可能预示着侧弯进展的风险更大。研究的进展可能会揭示基于该疾病潜在发病机制的新的预测因素。
