Cheung Jason Pui Yin, Luk Keith Dip-Kei
Department of Orthopaedics and Traumatology, The University of Hong Kong, Kong SAR, China.
Asian Spine J. 2017 Oct;11(5):804-816. doi: 10.4184/asj.2017.11.5.804. Epub 2017 Oct 11.
Management of pediatric spinal deformities requires an accurate prediction of growth spurts to allow for timely initiation of treatment and prevention of curve progression. Determining remaining growth potential is also important for avoiding prolonged unnecessary treatment, e.g. bracing for patients nearing skeletal maturity. Many clinical and radiological growth parameters have been developed to aid clinicians in growth prediction. Of these, several commonly used measures such as height and arm span growth trends, timing of menarche, and the Risser sign are mostly retrospective and lack strong predictive utility. Bone age assessments, such as digital skeletal age and the distal radius and ulna classification, are more accurate parameters, but further research is required to determine interethnic variations and develop their role in management decisions.
小儿脊柱畸形的管理需要准确预测生长突增，以便及时开始治疗并预防侧弯进展。确定剩余生长潜力对于避免长期不必要的治疗也很重要，例如对接近骨骼成熟的患者进行支具治疗。已经开发了许多临床和放射学生长参数来帮助临床医生进行生长预测。其中，一些常用的测量方法，如身高和臂展生长趋势、月经初潮时间和里塞尔征，大多是回顾性的，缺乏强大的预测效用。骨龄评估，如数字骨骼年龄和桡骨远端及尺骨分类，是更准确的参数，但需要进一步研究以确定种族间差异，并明确其在管理决策中的作用。
