青少年特发性脊柱侧凸的治疗进展

青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)是指年龄在10¹8岁,冠状面上Cobb角>10°伴有椎体的旋转而无其他器质性病变的一种常见病。该疾病能够导致身体外观畸形、疼痛,甚至心肺功能受损,严重影响了患者的身心健康及生活质量。在治疗上,对于轻中度的AIS患者常用定期观察、支具等保守治疗方法,能够有效的延缓侧凸的进展;对于保守治疗无效,达到手术阈值的AIS患者,则建议手术治疗,目前较为常用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,往往能够达到较好的临床疗效。近年来,由于物理治疗性脊柱侧凸特异性运动(PSSE)疗法安全有效,越来越受欢迎。目前对于AIS患者治疗的具体适应证正逐渐完善,治疗理念与技术在不断更新,临床疗效也不断得到改善。本文将从保守治疗和手术治疗两方面展开,主要阐述常用的治疗方法在临床上的进展和应用以及所面临的问题,为临床治疗的选择提供参考。

Progress on the treatment of adolescent idiopathic scoliosis

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.