Jinnah Alexander H, Lynch Kyle A, Wood Taylor R, Hughes Michael S
Wake Forest School of Medicine, Department of Orthopaedic Surgery, 1 Medical Center Blvd, Winston Salem, NC, 27103, USA.
Curr Rev Musculoskelet Med. 2025 Feb;18(2):54-60. doi: 10.1007/s12178-024-09939-2. Epub 2024 Dec 30.
Adolescent idiopathic scoliosis (AIS) is a disabling spinal pathology, with a significant morbidity if left untreated. This review investigates the recent advances in the diagnosis and management of AIS.
Low radiation techniques have become a paramount focus in the management of patient's with AIS. The EOS system is growing in popularity due to lower radiation compared to conventional radiographs with the added advantage allowing 3D reconstruction. Bracing remains the standard treatment for curves amenable to this, however, due to the importance in compliance with brace wear there has been a recent push for more personalized brace construction using 3-dimensional printing. If curves are not amenable to bracing, then surgical intervention is generally recommended. Posterior spinal fusion (PSF) remains the gold standard; however, newer growth modulating techniques are in their infancy. Anterior vertebral body tethering (VBT) is a relatively novel method of treatment for AIS, that has seen promising early results. Due to its novelty and varying results VBT use remains limited and will need to be further investigated. AIS is a complex disease without a clear understanding of it's etiology. If identified earlier, then non-operative treatment may lead to prevention of curve progression and the need for surgical intervention. Newer technologies, such as the EOS system, allow 3D reconstruction of curves which can assist with pre-operative planning. PSF remains the gold standard surgical intervention for AIS, however, new developments in alternative techniques could have a promising future, especially for skeletally immature patients.
青少年特发性脊柱侧凸（AIS）是一种致残性脊柱疾病，若不治疗会导致严重发病率。本综述探讨AIS诊断和治疗的最新进展。
低辐射技术已成为AIS患者治疗的首要关注点。与传统X线片相比，EOS系统因辐射较低且具有3D重建的额外优势而越来越受欢迎。支具仍然是适合支具治疗的侧弯的标准治疗方法，然而，由于依从性佩戴支具很重要，最近有人推动使用3D打印制作更个性化的支具。如果侧弯不适合支具治疗，通常建议进行手术干预。后路脊柱融合术（PSF）仍然是金标准；然而，更新的生长调节技术尚处于起步阶段。椎体前路栓系术（VBT）是一种相对新颖的AIS治疗方法，已取得了有前景的早期结果。由于其新颖性和结果各异，VBT的应用仍然有限，需要进一步研究。AIS是一种复杂疾病，其病因尚不清楚。如果能更早发现，非手术治疗可能会预防侧弯进展以及避免手术干预的必要性。诸如EOS系统等新技术可对侧弯进行3D重建，有助于术前规划。PSF仍然是AIS的金标准手术干预方法，然而，替代技术的新进展可能有光明的未来，特别是对于骨骼未成熟的患者。
