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青少年特发性脊柱侧凸:基层医生常问的问题。

Adolescent idiopathic scoliosis for the primary care physician: frequently asked questions.

机构信息

Orthopedic Surgery Department, Hotel-Dieu de France Hospital, Saint-Joseph University, Achrafieh, Beirut, Lebanon.

出版信息

Curr Opin Pediatr. 2019 Feb;31(1):48-53. doi: 10.1097/MOP.0000000000000705.

Abstract

PURPOSE OF REVIEW

Provide primary care physicians with the best available evidence to support answers to frequently asked questions by caregivers of patients with adolescent idiopathic scoliosis (AIS).

RECENT FINDINGS

A review of best available evidence shows that schoolbag design and weight are not associated with higher odds of developing AIS. However, patients with AIS are more prone to balance problems with asymmetric backpack carrying and with rising weights. In patients with AIS, the backpack should be worn in a symmetric way and should never exceed 10% of the child's body weight. Although no relationship was found between systematic exercising in general and development of AIS, classical ballet and professional swimming in skeletally immature adolescents were associated to higher odds of having AIS. Since AIS affects adolescent girls mainly, women health issues are of paramount importance in this disease. Except for limited sexual activity and higher need for infertility treatment, patients with AIS perform similar to controls in marriage rates, age at first pregnancy, gestational age, offspring, labor and delivery. Best available evidence shows that adults with AIS diagnosed during adolescence have similar physical activity level compared with controls. In patients with AIS, adults with surgically treated idiopathic scoliosis have slightly lower physical activity level than previously braced and untreated patients.

SUMMARY

Although schoolbag weight isn't associated with higher odds of developing AIS, classical ballet and professional swimming in adolescents are. Except for limited sexual activity, patients with AIS perform similar to controls in remaining women health issues. Adults with AIS diagnosed during adolescence have similar physical activity level compared with controls.

摘要

目的综述

为初级保健医生提供最佳的现有证据,以支持回答照顾青少年特发性脊柱侧凸(AIS)患者的护理人员经常提出的问题。

最新发现

对最佳现有证据的回顾表明,书包的设计和重量与发生 AIS 的几率增加无关。然而,患有 AIS 的患者在使用不对称背包和背包重量增加时更容易出现平衡问题。对于患有 AIS 的患者,背包应对称佩戴,且不应超过儿童体重的 10%。虽然一般的系统锻炼与 AIS 的发展之间没有发现任何关系,但在骨骼未成熟的青少年中,古典芭蕾舞和专业游泳与发生 AIS 的几率较高有关。由于 AIS 主要影响青春期女孩,因此女性健康问题在这种疾病中至关重要。除了有限的性行为和更高的不孕治疗需求外,患有 AIS 的患者在结婚率、首次怀孕年龄、胎龄、子女、分娩方面与对照组相似。最佳现有证据表明,青少年时期诊断出患有 AIS 的成年人的身体活动水平与对照组相似。在 AIS 患者中,接受手术治疗的特发性脊柱侧凸的成年人的身体活动水平略低于以前接受过支具治疗和未接受治疗的患者。

总结

尽管书包重量与发生 AIS 的几率增加无关,但青少年时期的古典芭蕾舞和专业游泳与之有关。除了有限的性行为外,患有 AIS 的患者在其余女性健康问题上与对照组相似。青少年时期诊断出患有 AIS 的成年人的身体活动水平与对照组相似。

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