Weiss Hans-Rudolf, Karavidas Nikos, Moramarco Marc, Moramarco Kathryn
Gesundheitsforum Nahetal, Gensingen, Germany.
Scoliosis Best Practice Rehab Services, Athens-Thessaloniki, Greece.
Asian Spine J. 2016 Dec;10(6):1163-1169. doi: 10.4184/asj.2016.10.6.1163. Epub 2016 Dec 8.
Currently, adolescent idiopathic scoliosis (AIS) is principally regarded as benign, but some researchers have cited serious or extreme effects, including severe pain, cardiopulmonary compromise, social isolation, and even early death. Therefore, exploration of the long-term effects of AIS, the most common type of idiopathic scoliosis, is warranted. The purpose of this review was to examine the long-term studies on the natural history of AIS and/or reviews concerning the long-term effects of untreated AIS. A PubMed search was conducted using the key words idiopathic scoliosis, long-term effects and idiopathic scoliosis, natural history. For further analysis, references cited in those studies were reviewed for additional, related evidence not retrieved in the initial PubMed search. A review of the pertinent bibliography showed that older natural history studies did not distinguish between late-onset scoliosis (referred to in this paper as AIS) and early-onset scoliosis (EOS). The more recent studies offer such important distinction and reach to the general conclusion that untreated AIS does not lead to severe consequences with respect to signs and symptoms of scoliosis. It is possible that earlier studies may have included patient populations with EOS, leading to the perception of untreated scoliosis as having an unusually high morbidity rate. Studies on the long-term effects of AIS that specifically excluded EOS patients conclude that AIS is a benign disorder. This indicates that for research and reporting purposes, it is important to distinguishing between AIS and EOS. This will allow the practitioner and patient and their families to decide on an optimal treatment plan based on the most appropriate prognosis.
目前，青少年特发性脊柱侧凸（AIS）主要被视为良性疾病，但一些研究人员提到了其严重或极端影响，包括剧痛、心肺功能受损、社交孤立，甚至过早死亡。因此，有必要探究AIS（特发性脊柱侧凸最常见的类型）的长期影响。本综述的目的是研究关于AIS自然史的长期研究和/或有关未经治疗的AIS长期影响的综述。使用关键词“特发性脊柱侧凸”“长期影响”以及“特发性脊柱侧凸”“自然史”在PubMed上进行了检索。为了进一步分析，对这些研究中引用的参考文献进行了审查，以获取在最初的PubMed检索中未检索到的其他相关证据。对相关文献的综述表明，早期的自然史研究没有区分晚发性脊柱侧凸（本文称为AIS）和早发性脊柱侧凸（EOS）。最近的研究进行了这种重要区分，并得出一般结论：未经治疗的AIS在脊柱侧凸的体征和症状方面不会导致严重后果。早期研究可能纳入了EOS患者群体，导致人们认为未经治疗的脊柱侧凸发病率异常高。专门排除EOS患者的关于AIS长期影响的研究得出结论，AIS是一种良性疾病。这表明，出于研究和报告目的，区分AIS和EOS很重要。这将使从业者、患者及其家属能够根据最合适的预后制定最佳治疗方案。
