NATURAL HISTORY AND SCHOOL SCREENING FOR SCOLIOSIS
NATURAL HISTORY AND SCHOOL SCREENING FOR SCOLIOSIS
复制标题
脊柱侧弯的自然史和学校筛查
DOI：
--
复制
发表时间：
1988
期刊：
影响因子：
--
通讯作者：
J. Lonstein
中科院分区：
文献类型：
--
作者：
J. Lonstein
鉴于有关学校脊柱畸形筛查的问题和争议，这些项目应该被取消吗？其自然史尚不完全清楚，非手术治疗的结果也受到质疑。由于过度转诊和大量的医生就诊和放射照片，费用很高。等到流行病学的问题得到答案不是最好的吗？最好的方法是在中间地带。该方案需要组织和加强。通过对筛查人员的教育，可以减少过度转诊。主治医生必须确认身体检查结果，拍摄适当的X线片，并计划适当的随访。这样，成本就会降低。此外，随着自然历史的知识，只有更大的曲线或渐进曲线将被处理。特发性脊柱侧凸的非手术治疗是有效的。它可以控制进展，甚至导致某些曲线的校正。支具和电刺激的整体效果需要不断审查。这些形式的非手术治疗如何影响渐进性弯曲，它们是否减少了特发性脊柱侧凸的手术需求？只有在我们对自然史和非手术治疗的结果进行更多的研究之后，才能重新评估脊柱侧凸的筛查，以确定其在脊柱畸形的整体治疗方案中的作用。
In light of the questions and controversy regarding school screening for spinal deformities, should the programs be dropped? The natural history is not completely known and the results of nonoperative treatment questioned. The costs are high due to over-referral and numerous physician visits and radiographs. Would it not be best to wait until the epidemiologic questions are answered? The best approach is one in the middle ground. The program needs to be organized and strengthened. With the education of screeners, over-referral can be reduced. The treating physician must confirm the physical finding, take appropriate radiographs, and plan appropriate follow-up. In this way, the costs will be reduced. In addition, with knowledge regarding natural history, only larger curves or progressive curves will be treated. Nonoperative treatment of idiopathic scoliosis is effective. It can control progression and even result in correction of some curves. The overall effectiveness of braces and electrical stimulation needs to be constantly reviewed. How do these forms of nonoperative treatment affect the progressive curve, and do they reduce the need for surgery in idiopathic scoliosis? Only after we have more studies on natural history and on the results of nonoperative treatment can screening for scoliosis be reassessed to determine its role in the overall treatment program of spinal deformities.