Renshaw T S
Newington Children's Hospital, CT 06111.
Clin Orthop Relat Res. 1988 Apr(229):26-33.
Idiopathic scoliosis can be detected by early screening of school children in school clinics, a method which improves the detection rate. By early detection, many curves that would require surgical treatment can be prevented from reaching that severe magnitude. Much valuable data regarding the natural history of idiopathic scoliosis have been derived from screening programs. On the other hand, costs of screening are not inconsequential, and costs involved in follow-up procedures are high. Vast numbers of small, nonprogressive curves are discovered and followed. Several questions remain. (1) At what ages should school children be screened? (2) Should boys be screened? (3) What should be the criteria for referral or treatment? (4) What is a reasonable follow-up program? (5) How effective is nonoperative treatment? Careful study of the natural history and treatment of idiopathic scoliosis will help to answer these questions.
特发性脊柱侧凸可通过在学校诊所对学童进行早期筛查来检测，这种方法可提高检出率。通过早期发现，可以防止许多原本需要手术治疗的侧弯发展到严重程度。关于特发性脊柱侧凸自然史的许多有价值的数据都来自筛查项目。另一方面，筛查成本并非微不足道，后续程序的成本也很高。发现并跟踪了大量小型、非进行性的侧弯。仍有几个问题存在。（1）应该在什么年龄对学童进行筛查？（2）男孩是否应该接受筛查？（3）转诊或治疗的标准应该是什么？（4）合理的随访方案是什么？（5）非手术治疗的效果如何？对特发性脊柱侧凸的自然史和治疗进行仔细研究将有助于回答这些问题。
