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早发性脊柱侧弯的治疗策略。

Treatment strategies for early-onset scoliosis.

作者信息

Helenius Ilkka J

机构信息

Department of Pediatric Orthopedic Surgery, University of Turku and Turku University Hospital, Turku, Finland.

出版信息

EFORT Open Rev. 2018 May 21;3(5):287-293. doi: 10.1302/2058-5241.3.170051. eCollection 2018 May.

Abstract

Early-onset scoliosis (EOS) is defined as a spinal deformity occurring before the age of ten years.Untreated EOS or early spinal fusion resulting in a short spine is associated with increased mortality and cardiopulmonary compromise.EOS may progress rapidly, and therefore prompt clinical diagnosis and referral to a paediatric orthopaedic or spine unit is necessary.Casting under general anaesthesia can be effective and may prevent or delay the need for surgery in curves of less than 60°.'Growing' rods (traditional or magnetically-controlled) represent the standard surgical treatment in progressive curves of 45° or greater.Children with congenital scoliosis associated with fused ribs benefit from surgery with a vertical titanium prosthetic rib.Surgery with growth-friendly instrumentation is associated with a high risk of complications. Cite this article: 2018;3 DOI: 10.1302/2058-5241.3.170051.

摘要

早发性脊柱侧弯(EOS)被定义为在十岁之前出现的脊柱畸形。未经治疗的EOS或早期脊柱融合导致脊柱短小与死亡率增加和心肺功能受损有关。EOS可能进展迅速,因此及时进行临床诊断并转诊至小儿骨科或脊柱专科是必要的。全身麻醉下的石膏固定可能有效,并且对于小于60°的侧弯可能预防或延迟手术需求。“生长型”棒(传统的或磁控的)是45°或更大的进行性侧弯的标准手术治疗方法。伴有肋骨融合的先天性脊柱侧弯儿童受益于垂直钛制人工肋骨手术。采用有利于生长的器械进行手术会有较高的并发症风险。引用本文:2018;3 DOI:10.1302/2058-5241.3.170051。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d41/5994631/5083236c9044/eor-3-287-g001.jpg

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