Gunnoe B A
Department of Orthopaedics, Loma Linda University Medical Center, California.
Orthop Rev. 1990 Jan;19(1):35-43.
The effective treatment of adolescent idiopathic scoliosis (AIS) is predicted on timely detection and appropriate intervention. School screening programs have resulted in a reduced incidence of advanced curvature upon referral. Studies of the natural history of AIS demonstrate that a number of factors are of predictive value in assigning risk for progressive curvature and subsequent deformity and/or morbidity. These are age at time of diagnosis, stage of skeletal maturity, and magnitude and pattern of curvature. The options in treating AIS are observation, orthosis, and operation. Spinal orthoses are designed to arrest the progression of curvature during skeletal maturation. Newer brace designs and protocols facilitate compliance with long-term bracing and may reduce the incidence of curves requiring operative intervention. The goal in scoliosis surgery is to reduce curvature and to create a stable framework on which vertebral fusion can occur. Technical advances have yielded a number of instrumentation options for achieving this goal. Basic technical comparisons are made among of prototypes of posterior spinal instrumentation. The newest of these, Cotrel-Dubousset, may supplant Harrington rod instrumentation as the preferred standard in the operative treatment of AIS.
青少年特发性脊柱侧凸（AIS）的有效治疗取决于及时发现和适当干预。学校筛查项目已使转诊时严重脊柱侧弯的发病率降低。对AIS自然病史的研究表明，一些因素在确定进展性脊柱侧弯及后续畸形和/或发病风险方面具有预测价值。这些因素包括诊断时的年龄、骨骼成熟阶段、脊柱侧弯的程度和模式。治疗AIS的选择包括观察、使用矫形器和手术。脊柱矫形器旨在在骨骼成熟期间阻止脊柱侧弯进展。更新的支具设计和方案有助于长期佩戴支具，并可能降低需要手术干预的脊柱侧弯发病率。脊柱侧弯手术的目标是减少脊柱侧弯并建立一个能实现椎体融合的稳定结构。技术进步带来了多种实现这一目标的器械选择。对脊柱后路器械原型进行了基本技术比较。其中最新的Cotrel-Dubousset器械可能会取代哈灵顿棒器械，成为AIS手术治疗的首选标准。
