York Philip J, Kim Han Jo
Department of Orthopaedic Surgery, University of Colorado, Aurora, CO, USA.
Hospital for Special Surgery, New York, NY, 10021, USA.
Curr Rev Musculoskelet Med. 2017 Dec;10(4):547-558. doi: 10.1007/s12178-017-9445-0.
The purpose of this review is to provide an updated review of adult degenerative scoliosis (ADS). Epidemiology, classification, pathophysiology, and natural history are discussed along with a summary of commonly used outcome measures. Operative vs non-operative outcomes and new surgical techniques are discussed.
The SRS-Schwab classification (2012) combines clinical and radiographic evaluation including overall global alignment. Current evidence regarding risk factors and efficacy of non-surgical modalities are discussed. Recent studies have reported surgical management to provide superior outcomes to non-operative modalities. New surgical techniques provide promising early data in regard to decreasing perioperative morbidity. ADS is a potentially debilitating condition that occurs with asymmetric spinal degeneration. This can produce global sagittal malalignment and central and foraminal stenosis and can lead to significant impairment often necessitating surgery. The surgeon must be aware of the perioperative risks in this population and implement appropriate age-specific alignment goals to achieve the best outcome for patients.
本综述旨在提供关于成人退变性脊柱侧凸(ADS)的最新综述。文中讨论了其流行病学、分类、病理生理学和自然史,并总结了常用的疗效评估指标。还讨论了手术与非手术治疗的结果以及新的手术技术。
SRS-Schwab分类(2012年)结合了临床和影像学评估,包括整体矢状面排列。文中讨论了有关非手术治疗方式的风险因素和疗效的当前证据。近期研究报告称,手术治疗的效果优于非手术治疗方式。新的手术技术在降低围手术期发病率方面提供了有前景的早期数据。成人退变性脊柱侧凸是一种因脊柱不对称退变而发生的、可能使人衰弱的疾病。这可导致整体矢状面排列不齐以及中央和椎间孔狭窄,并可导致严重功能障碍,常常需要手术治疗。外科医生必须了解该人群的围手术期风险,并实施适当的针对特定年龄的排列目标,以实现患者的最佳治疗效果。