Cao Jun,Zhang Xuejun.Systemic treatments of pediatric early-onset scoliosis[J].Journal of Clinical Pediatric Surgery,2021,20(01):1-5.[doi:10.12260/lcxewkzz.2021.01.001]
儿童早发性脊柱侧弯的系统治疗
- Title:
- Systemic treatments of pediatric early-onset scoliosis
- Keywords:
- Scoliosis/SU; Scoliosis/TH; Systematic Treatment; Spinal Fusion; Non-Fusion Surgery; Child
- 分类号:
- R726.8;R682.3
- 摘要:
- 早发性脊柱侧弯是儿童脊柱外科乃至儿童骨科治疗的难点,需要在术前进行详细检查,若存在其他畸形则需要联合相应学科进行评估。早发性脊柱侧弯的治疗方法包括非手术治疗和手术治疗,其中手术治疗分为融合手术与非融合手术,需要根据病情和儿童发育特点采用合适的治疗方法,并不断调整,以达到系统化治疗的目的。其治疗目标不应是仅仅矫正脊柱畸形,维持正常脊柱和胸廓发育、减少并发症和促进整体健康也必须纳入考虑的范畴。
- Abstract:
- As a management dilemma in pediatric orthopedics and spinal surgery,early onset scoliosis (EOS) requires thorough preoperative examinations and deformities beyond orthopedics need the consultations of multiple specialties.Current management options for EOS include non-surgical measures and surgery (including fusion and non-fusion).Systemic managements of EOS require appropriate interventions constant adjustments according to specific conditions and developmental characteristics of children.The therapeutic objective is not only focusing upon spinal malformations,but also maintaining normal spinal and thoracic developments,reducing the occurrences of complications and promoting overall health.
参考文献/References:
1 El-Hawary R,Akbarnia BA.Early onset scoliosis-time for consensus[J].Spine Deform,2015,3(2):105-106.DOI:10.1016/j.jspd.2015.01.003.
2 Williams BA,Matsumoto H,McCalla DJ,et al.Development and initial validation of the classification of early-onset scoliosis (C-EOS)[J].J Bone Joint Surg Am,2014,96(16):1359-1367.DOI:10.2106/JBJS.M.00253.
3 郭东,曹隽,张学军,等.先天性脊柱畸形合并椎管内神经系统畸形发病因素分析[J].临床小儿外科杂志,2010,9(4):255-257.DOI:10.3969/j.issn.1671-6353.2010.04.005.Guo D,Cao J,Zhang XJ,et al.Pathogenic factors of congenital spinal cord with intraspinal nervous system malformations[J].J Clin Ped Sur,2010,9(4):255-257.DOI:10.3969/j.issn.1671-6353.2010.04.005.
4 曹隽,孙琳,宋宏程,等.先天性脊柱畸形合并泌尿生殖系统畸形发病情况及相关因素分析[J].中华小儿外科杂志,2010,31(1):27-29.DOI:10.3760/cma.j.issn.0253-3006.2010.01.008.Cao J,Sun L,Song HC,et al.Prevalence and factors of congenital spinal cord and urogenital system malformations[J].Chin J Pediatr Surg,2010,31(1):27-29.DOI:10.3760/cma.j.issn.0253-3006.2010.01.008.
5 曹隽,郭东,孙琳,等.先天性脊柱侧弯合并肋骨畸形及其对肺功能影响的分析[J].临床小儿外科杂志,2015,14(3):178-182.DOI:10.3969/j.issn.1671-6353.2015.03.005.Cao J,Guo D,Sun L,et al.Congenital scoliosis with rib malformations and its effect upon pulmonary functions[J].J Clin Ped Sur,2015,14(3):178-182.DOI:10.3969/j.issn.1671-6353.2015.03.005.
6 曹隽,张学军,曾骐,等.Nuss手术治疗漏斗胸患儿合并特发性脊柱侧弯的临床研究[J].临床小儿外科杂志,2019,18(1):13-17.DOI:10.3969/j.issn.1671-6353.2019.01.004.Cao J,Zhang XJ,Zeng Q,et al.Clinical trial of Nuss surgery for children of pectus excavatum with idopathic scoliosis[J].J Clin Ped Sur,2019,18(1):13-17.DOI:10.3969/j.issn.1671-6353.2019.01.004.
7 Campbell RM Jr,Smith MD,Mayes TC,et al.The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis[J].J Bone Joint Surg Am,2003,85(3):399-408.DOI:10.2106/00004623-200303000-00001.
8 Mehta MH.Growth as a corrective force in the early treatment of progressive infantile scoliosis[J].J Bone Joint Surg Br,2005,87(9):1237-1247.DOI:10.1302/0301-620X.87B9.16124.
9 Cao J,Zhang XJ,Sun N,et al.The therapeutic characteristics of serial casting on congenital scoliosis:a comparison with non-congenital cases from a single-center experience[J].J Orthop Surg Res,2017,12(1):56.DOI:10.1186/s13018-017-0554-7.
10 Guo D,Yao Z,Qi X,et al.Short fixation with a 3-rod technique for posterior hemivertebra resection in children younger than 5 years old[J].Pediatr Investig,2020,4(2):104-108.DOI:10.1002/ped4.12206.
11 Bess S,Akbarnia BA,Thompson GH,et al.Complications of growing-rod treatment for early-onset scoliosis:analysis of one hundred and forty patients[J].J Bone Joint Surg Am,2010,92(15):2533-2543.DOI:10.2106/JBJS.I.01471.
12 Guille JT,D’ Andrea LP,Betz RR.Fusionless treatment of scoliosis[J].Orthop Clin North Am,2007,38(4):541-545.DOI:10.1016/j.ocl.2007.07.003.
13 Crawford CR,Lenke LG.Growth modulation by means of anterior tethering resulting in progressive correction of juvenile idiopathic scoliosis:a case report[J].J Bone Joint Surg Am,2010,92(1):202-209.DOI:10.2106/JBJS.H.01728.
14 McCarthy RE,Luhmann S,Lenke L,et al.The Shilla growth guidance technique for early-onset spinal deformities at 2-year follow-up:a preliminary report[J].J Pediatr Orthop,2014,34(1):1-7.DOI:10.1097/BPO.0b013e31829f92dc.
15 Wang S,Zhang J,Qiu G,et al.One-stage posterior osteotomy with short segmental fusion and dual growing rod technique for severe rigid congenital scoliosis:the preliminary clinical outcomes of a hybrid technique[J].Spine (Phila Pa 1976),2014,39(4):E294-E299.DOI:10.1097/BRS.0000000000000119.
相似文献/References:
[1]程富礼 孙琳 于凤章 景小博 张庆玉. 应用改良皮下棒技术治疗小儿脊柱侧凸13例[J].临床小儿外科杂志,2011,10(02):151.
[J].Journal of Clinical Pediatric Surgery,2011,10(01):151.
[2]王继孟,张敏刚,王恒冰,等.半椎体切除术治疗先天性脊柱侧凸30例[J].临床小儿外科杂志,2008,7(02):7.
[3]杨红军,杨建平,曾裴,等.不同术式早期治疗半椎体型先天性脊柱侧弯的临床疗效比较[J].临床小儿外科杂志,2007,6(01):26.
[4]郭东,高荣轩,姚子明,等.儿童腰骶部半椎体一期后路切除短节段固定治疗效果分析[J].临床小儿外科杂志,2020,19(07):596.[doi:10.3969/j.issn.1671-6353.2020.07.007]
Guo Dong,Gao Rongxuan,Yao Ziming,et al.One-stage posterior-only lumbosacral hemivertebra resection with short-segment internal fixation and fusion in children[J].Journal of Clinical Pediatric Surgery,2020,19(01):596.[doi:10.3969/j.issn.1671-6353.2020.07.007]
[5]刘昊楠,张学军,李多依,等.加速康复外科模式在先天性脊柱侧凸患者围手术期治疗中的应用研究[J].临床小儿外科杂志,2021,20(05):447.[doi:10.12260/lcxewkzz.2021.05.010]
Liu Haonan,Zhang Xuejun,Li Duoyi,et al.Efficacy of enhanced recovery after surgery for children with congenital spinal scoliosis during perioperative period[J].Journal of Clinical Pediatric Surgery,2021,20(01):447.[doi:10.12260/lcxewkzz.2021.05.010]
[6]周小松,胡璟,李多依,等.儿童脊柱侧弯矫形术围手术期低体温的相关因素分析[J].临床小儿外科杂志,2022,21(09):855.[doi:10.3760/cma.j.cn101785-202110002-011]
Zhou Xiaosong,Hu Jing,Li Duoyi,et al.Influencing factors for perioperative hypothermia in children undergoing scoliosis correction surgery[J].Journal of Clinical Pediatric Surgery,2022,21(01):855.[doi:10.3760/cma.j.cn101785-202110002-011]
[7]朱伟玮,张学军,曹隽,等.生长棒近端锚定点数量对早发性脊柱侧凸疗效及并发症的影响[J].临床小儿外科杂志,2021,20(01):14.[doi:10.12260/lcxewkzz.2021.01.003]
Zhu Weiwei,Zhang Xuejun,Cao Jun,et al.Comparison of the Results of Different Number of Proximal Anchor Points on Growing Rod Technique in the Treatment of Early Onset Scoliosis[J].Journal of Clinical Pediatric Surgery,2021,20(01):14.[doi:10.12260/lcxewkzz.2021.01.003]
[8]李海侠,吴继功,宋立志,等.支具治疗进展型早发性脊柱侧弯的临床研究[J].临床小儿外科杂志,2021,20(01):24.[doi:10.12260/lcxewkzz.2021.01.005]
Li Haixia,Wu Jigong,Song Lizhi,et al.Title Clinical study of brace in the treatment of progressive early-onset scoliosis[J].Journal of Clinical Pediatric Surgery,2021,20(01):24.[doi:10.12260/lcxewkzz.2021.01.005]
[9]白云松,张学军,曹隽,等.双侧生长棒技术治疗早发性脊柱侧凸的疗效分析[J].临床小儿外科杂志,2021,20(01):29.[doi:10.12260/lcxewkzz.2021.01.006]
Bai Yunsong,Zhang Xuejun,Cao Jun,et al.Efficacy of bilateral growth rods in the treatment of early-onset scoliosis[J].Journal of Clinical Pediatric Surgery,2021,20(01):29.[doi:10.12260/lcxewkzz.2021.01.006]
[10]王姗姗,周璇,杜青.早发型脊柱侧凸保守治疗的研究进展[J].临床小儿外科杂志,2021,20(01):33.[doi:10.12260/lcxewkzz.2021.01.007]
Wang Shanshan,Zhou Xuan,Du Qing.Research progress on conservative treatment of early onset scoliosis[J].Journal of Clinical Pediatric Surgery,2021,20(01):33.[doi:10.12260/lcxewkzz.2021.01.007]
[11]朱伟玮,叶文松.生长棒技术治疗早发性先天性脊柱侧凸的研究进展[J].临床小儿外科杂志,2021,20(07):681.[doi:10.12260/lcxewkzz.2021.07.017]
Zhu Weiwei,Ye Wensong.Recent advances in the treatment of early-onset congenital scoliosis with growing rod technique[J].Journal of Clinical Pediatric Surgery,2021,20(01):681.[doi:10.12260/lcxewkzz.2021.07.017]
备注/Memo
收稿日期:2020-07-14。
基金项目:北京市医院管理局2018年度"杨帆"计划临床技术创新项目(编号:XMLX201818)
通讯作者:张学军,Email:zhang-x-j04@163.com