Departments of1Neurosurgery and.
2Political Science, University of South Alabama, Mobile, Alabama.
Neurosurg Focus. 2024 Aug 1;57(2):E11. doi: 10.3171/2024.6.FOCUS24240.
The goal of this study is to discuss the transitional nature of idiopathic scoliosis and the variation in treatment and management across the spectrum of age presentation.
This is a review article that discusses the evaluation, management, and classification of idiopathic scoliosis. The authors searched PubMed/MEDLINE, Google Scholar, and the Cochrane database for articles published up to April 2024. Keywords and MeSH terms relevant to the topic were used, including adolescent idiopathic scoliosis (AIS), adult idiopathic scoliosis (AdIS), adult degenerative scoliosis, young adult idiopathic scoliosis, early-onset scoliosis (EOS), classification, management, follow-up, outcomes, natural history, Cobb angle, and transitional care. Reference lists of selected articles were also searched to identify further articles. Inclusion criteria included English language articles that summarized any type of study design, including randomized controlled trials, observational studies, case-control/series, or metaanalysis, with study populations ranging from infants to > 50-year-old patients. Inter-reviewer disagreement on inclusion of particular articles was resolved through discussion. Related information was analyzed, and relevant concepts related to the transitional period dilemma have been discussed.
Each idiopathic scoliosis case needs independent assessment with regard to the age, degree of the curve, and patient-specific presentation. An accurate prediction of the curve progression by considering the patient's remaining growth potential is paramount to the treatment strategy. The classification system for EOS, AIS Lenke classification, AdIS classification, and the Scoliosis Research Society-Schwab classification are important for reliable communication between surgeons treating deformities. Untreated progressive idiopathic scoliosis warrants multidisciplinary management during the transition from EOS stage to AIS and then to AdIS. Also, surgical treatment of untreated AIS transitioning to AdIS is specific and nuanced. AdIS needs to be differentiated from adult degenerative scoliosis because the latter is associated with multiple comorbidities and anatomical differences.
Idiopathic scoliosis presents across the age spectrum with specific age-related decisions that transition into adulthood. Integrated models of both surgical and nonsurgical treatment of idiopathic scoliosis are warranted.
本研究旨在探讨特发性脊柱侧凸的过渡性本质，以及在不同年龄段表现出的治疗和管理方式的变化。
这是一篇综述文章，讨论了特发性脊柱侧凸的评估、管理和分类。作者检索了 PubMed/MEDLINE、Google Scholar 和 Cochrane 数据库，以获取截至 2024 年 4 月发表的文章。使用了与主题相关的关键词和 MeSH 术语，包括青少年特发性脊柱侧凸（AIS）、成人特发性脊柱侧凸（AdIS）、成人退行性脊柱侧凸、青年特发性脊柱侧凸、早发性脊柱侧凸（EOS）、分类、管理、随访、结果、自然史、Cobb 角和过渡性护理。还检索了选定文章的参考文献列表，以确定其他文章。纳入标准包括总结任何类型研究设计的英文文章，包括随机对照试验、观察性研究、病例对照/系列或荟萃分析，研究人群从婴儿到>50 岁的患者。对特定文章纳入的意见分歧通过讨论解决。分析了相关信息，并讨论了与过渡时期困境相关的相关概念。
每个特发性脊柱侧凸病例都需要根据年龄、曲度程度和患者特定表现进行独立评估。考虑到患者的剩余生长潜力，准确预测曲线进展对于治疗策略至关重要。EOS 的分类系统、AIS Lenke 分类、AdIS 分类和 Scoliosis Research Society-Schwab 分类对于治疗畸形的外科医生之间的可靠沟通很重要。未经治疗的进展性特发性脊柱侧凸需要在从 EOS 阶段过渡到 AIS 然后到 AdIS 期间进行多学科管理。此外，未经治疗的 AIS 向 AdIS 过渡的手术治疗具有特异性和细微差别。AdIS 需要与成人退行性脊柱侧凸区分开来，因为后者与多种合并症和解剖差异有关。
特发性脊柱侧凸在整个年龄范围内表现出与年龄相关的特定决策，这些决策会过渡到成年期。特发性脊柱侧凸的手术和非手术治疗的综合模式是必要的。
