Gong Lei, Fang Liang, Ye Xiao-Ling, Fan Yi-Song, Jiang Ying-Qiao, Tong Pei-Jian, Xiao Lu-Wei
The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China.
Zhongguo Gu Shang. 2020 Feb 25;33(2):184-9. doi: 10.12200/j.issn.1003-0034.2020.02.019.
Adolescent idiopathic scoliosis (AIS) is a common disease with the age of 10 to 18 years, the Cobb angle more than 10 ° on the coronal plane and combined with the rotation of the vertebral body without other organic lesions. The disease can lead to deformity, pain and even damage of cardiopulmonary function, which seriously affects the physical and mental health and quality of life of patients. For mild to moderate AIS patients, regular observation, braces and other conservative treatment methods can effectively delay the progress of scoliosis. For AIS patients whose conservative treatment is ineffective and reaches the surgical threshold, surgery is recommended. Currently, the prevalent surgical method is posterior vertebral body fusion represented by the pedicle screw internal fixation system, which can often achieve good clinical efficacy. In recent years, Physical Therapeutic Scoliosis Specific Exercise (PSSE) has become more and more popular because of its safety and effectiveness. At present, the specific indications for the treatment of AIS patients are gradually improving, the concept and technology of treatment are constantly updated, and the clinical efficacy is constantly improved. This article will start from two aspects of conservative treatment and surgical treatment, mainly describes the commonly used treatment methods in clinical progress and application as well as the problems faced, in order to provide a reference for the selection of clinical treatment.
青少年特发性脊柱侧凸(AIS)是一种常见疾病,发病年龄在10至18岁,冠状面上Cobb角大于10°,并伴有椎体旋转,无其他器质性病变。该疾病可导致畸形、疼痛,甚至心肺功能损害,严重影响患者的身心健康和生活质量。对于轻度至中度AIS患者,定期观察、支具等保守治疗方法可有效延缓脊柱侧凸的进展。对于保守治疗无效且达到手术阈值的AIS患者,建议进行手术。目前,流行的手术方法是以椎弓根螺钉内固定系统为代表的后路椎体融合术,通常能取得良好的临床疗效。近年来,物理治疗性脊柱侧凸特定运动(PSSE)因其安全性和有效性而越来越受欢迎。目前,AIS患者治疗的具体适应证在逐渐完善,治疗理念和技术不断更新,临床疗效不断提高。本文将从保守治疗和手术治疗两个方面入手,主要介绍临床进展和应用中的常用治疗方法以及面临的问题,以便为临床治疗的选择提供参考。