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休曼氏后凸畸形:病理生理学与外科治疗的最新进展

Scheuermann's kyphosis: update on pathophysiology and surgical treatment.

作者信息

Sebaaly Amer, Farjallah Sarah, Kharrat Khalil, Kreichati Gaby, Daher Mohammad

机构信息

School of Medicine, Saint Joseph University, Beirut, Lebanon.

Orthopedic Department, Spine Unit, Hotel Dieu de France Hospital, Beirut, Lebanon.

出版信息

EFORT Open Rev. 2022 Dec 7;7(11):782-791. doi: 10.1530/EOR-22-0063.

Abstract

Scheuermann's Kyphosis (SK) is a rigid spinal kyphosis. Several theories have been proposed concerning its pathogenesis, but it is, to this day, still unknown. It has a prevalence of 0.4-8.3% in the population with a higher incidence in females. Clinical examination with x-rays is needed to differentiate and confirm this diagnosis. Non-surgical management is reserved for smaller deformities and in skeletally immature patients, whereas surgery is recommended for higher deformities. Combined anterior and posterior approach was considered the gold standard for the surgical treatment of this disease, but there is an increasing trend toward posterior-only approaches especially with use of segmental fixation. This study reviews the pathophysiology of SK while proposing a treatment algorithm for its management.

摘要

休曼氏脊柱后凸(Scheuermann's Kyphosis,SK)是一种僵硬性脊柱后凸。关于其发病机制已提出多种理论,但时至今日仍不清楚。其在人群中的患病率为0.4% - 8.3%,女性发病率更高。需要通过X线进行临床检查以鉴别和确诊。非手术治疗适用于畸形较小的患者以及骨骼未成熟的患者,而对于畸形程度较高的患者则建议手术治疗。联合前后路手术曾被认为是该病手术治疗的金标准,但目前单纯后路手术的趋势日益增加,尤其是在使用节段性固定的情况下。本研究回顾了SK的病理生理学,同时提出了其治疗方案。

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