Adolescent idiopathic scoliosis: prevalence and natural history.
Adolescent idiopathic scoliosis: prevalence and natural history.
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发表时间：
1989
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通讯作者：
S. Weinstein
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作者：
S. Weinstein
本章所介绍的自然史只适用于AIS。其他类型的脊柱侧凸有其自身的自然病史和相关问题，可能会显著影响患者满足日常生活需求的能力。公众意识的提高和筛查诊所的增加，导致转介骨科就诊的儿童人数增加，最初发现的严重曲线幅度减少，治疗机构更早。每位患者的治疗必须个体化，考虑到基于曲线大小、骨骼成熟度、性成熟和年龄的曲线进展概率（表6-7）。必须避免过度诊断和不必要的治疗。随着我们对AIS自然史的了解的扩大，治疗决策可以基于客观而不是主观数据。任何治疗这种疾病的建议都必须有合理的机会以积极的方式改变自然历史。现有的自然史信息是在相对较小的患者群体中积累起来的，所提出的结论具有普遍性。AIS可能有许多“自然历史”，特别是关于曲线进程；因此，治疗决定必须个体化。对脊柱侧凸的各种治疗的长期结果必须考虑到疾病的自然历史。
The natural history presented in this chapter applies only to AIS. Other types of scoliosis have their own natural history and associated problems that may significantly affect the ability of the patient to meet the demands of daily life. Increased public awareness and screening clinics have resulted in an increased number of children referred for orthopaedic opinion, less severe curve magnitude at initial detection, and earlier institution of treatment. Treatment of each patient must be individualized, taking into consideration the probability of curve progression based on curve magnitude, skeletal maturity, sexual maturity, and age (Table 6-7). Overdiagnosis and unnecessary treatment must be avoided. As our knowledge of the natural history of AIS expands, treatment decisions can be based on objective rather than subjective data. Any proposed treatment of this condition must have a reasonable chance of altering the natural history in a positive way. The information available on natural history has been accumulated on relatively small groups of patients and the conclusions presented represent generalities. There are probably many "natural histories" for AIS, especially with reference to curve progression; therefore, treatment decisions must be individualized. Long-term results of various treatments for scoliosis must take into consideration the natural history of the disorder.