Wang Shanshan,Zhou Xuan,Du Qing.Research progress on conservative treatment of early onset scoliosis[J].Journal of Clinical Pediatric Surgery,2021,20(01):33-38.[doi:10.12260/lcxewkzz.2021.01.007]
早发型脊柱侧凸保守治疗的研究进展
- Title:
- Research progress on conservative treatment of early onset scoliosis
- Keywords:
- Scoliosis/SU; Scoliosis/TH; Scoliosis/RH
- 分类号:
- R726.8;R682.3
- 摘要:
- 早发型脊柱侧凸(early onset scoliosis,EOS)具有发病年龄小、进展迅速的特点,易造成患者脊柱生长异常及心肺功能障碍,是脊柱疾病领域的研究热点之一。EOS的治疗方法主要包括保守治疗与手术治疗,前者因创伤小、并发症少,且有利于患者的身心发展,常推荐作为治疗的第一步。保守治疗包括石膏治疗、支具治疗、脊柱侧凸特定运动疗法与Halo重力牵引等。对于特发性EOS,保守治疗可有效改善脊柱畸形,而对其他类型EOS则主要起到延缓畸形进展、推迟手术时间的作用。本文拟针对EOS常见的保守治疗方法进行深入阐述。
- Abstract:
- Early onset scoliosis (EOS) is characterized by early onset and rapid progress,and is easy to affect spine growth and cardiopulmonary function development in children.It is still a hot spot in the research of spinal diseases.The treatment of EOS includes conservative and surgical therapy.And the former is often recommended as the first step of treatment because of its less trauma and fewer complications,which is beneficial to the physical and mental development of children.The conservative treatment includes cast treatment,brace treatment,physiotherapy scoliosis specific exercises,traction treatment,etc.For idiopathic EOS,conservative treatment can effectively improve spinal deformity,while for congenital and other types of EOS,it mainly delays the progression of the deformity and operation time.This review intends to elaborate on the common conservative treatment methods of EOS to promote early treatment and rehabilitation of EOS.
参考文献/References:
1 Gao R,Sun B,Zhang X,et al.Reliability and Validity of the Simplified Chinese Early onset Scoliosis Quality of Life 24-Item Questionnaire [J].Spine,2021,46(2):e14-e17.DOI:10.1097/BRS.0000000000003736.
2 Karol LA.Early Definitive Spinal Fusion in Young Children:What We Have Learned[J].Clin Orthop Rel Res,2011,469(5):1323-1329.DOI:10.1007/s11999-010-1622-z.
3 李海侠,吴继功,宋立志,等.系列石膏及支具治疗进展型早发性脊柱侧凸的疗效分析[J].中华骨科杂志,2019,39(18):1108-1116.DOI:10.3760/cma.j.issn.0253-2352.2019.18.002.Li HX,Wu JG,Song LZ,et al.The effectiveness analysis of serial cast and bracing for progressive early-onset scoliosis[J].Chin J Orthop,2019,39(18):1108-1116.DOI:10.3760/cma.j.issn.0253-2352.2019.18.002.
4 Canavese F,Dimeglio A.Serial elongation derotation flexion casting in children with infantile and juvenile scoliosis[J].Ann Transl Med,2020,8(2):24.DOI:10.21037/atm.2019.08.108.
5 冯磊,张学军.儿童脊柱侧凸矫正手术中神经电生理监测方案的选择及技术难点[J].临床小儿外科杂志,2020,19(2):93-97.DOI:10.3969/j.issn.1671-6353.2020.02.001.Feng L,Zhang XJ.Protocol selecting and technical dilemmas of intraoperative neurophysiological monitoring during cor-rective procedures for pediatric scoliosis[J].J Clin Ped Sur,2020,19(2):93-97.DOI:10.3969/j.issn.1671-6353.2020.02.001.
6 Akbarnia BA,Campbell RM,Dimeglio A,et al.Fusionless procedures for the management of early-onset spine deformities in 2011:what do we know?[J].J Child Orthop,2011,5(3):159-72.DOI:10.1007/s11832-011-0342-6.
7 Li Y,Swallow J,Gagnier J,et al.A report of two conservative approaches to early onset scoliosis:serial casting and bracing[J].Spine Deform,2020.DOI:10.1007/s43390-020-00213-2.
8 Park JH, Jeon HS, Park HW.Effects of the Schroth exercise on idiopathic scoliosis:a meta-analysis[J].Eur J Phys Rehabil Med,2018,54(3):440-449.DOI:10.23736/S1973-9087.17.04461-6.
9 尹佳,张珂,林涛,等.早发性脊柱侧凸的手术治疗与并发症研究进展[J].临床小儿外科杂志,2018,17(9):15-19.DOI:10.3969/j.issn.1671-6353.2018.09.003.Yin J,Zhang K,Lin T,et al.Research progress on surgical treatment and complications of early-onset scoliosis[J].J Clin Ped Sur,2018,17(9):15-19.DOI:10.3969/j.issn.1671-6353.2018.09.003.
10 中国医师协会骨科医师分会,中国医师协会骨科医师分会《早发性脊柱侧凸循证临床诊疗指南》编辑委员会.中国医师协会骨科医师分会骨科循证临床诊疗指南:早发性脊柱侧凸循证临床诊疗指南[J].中华外科杂志,2019,57(3):166-169.DOI:10.10.3760/cma.j.issn.0529-5815.2019.03.002.Chinese Association of Orthopedic Surgeons,The Editorial Committee of the "Evidence-based guideline for the management of early onset scoliosis" of Chinese Association of Orthopedic Surgeons.Evidence-based guideline for the management of early onset scoliosis[J].Chin J Sur,2019,57(3):166-169.DOI:10.10.3760/cma.j.issn.0529-5815.2019.03.002.
11 Gussous YM,Tarima S,Zhao S,et al.Serial Derotational Casting in Idiopathic and Non-Idiopathic Progressive Early-Onset Scoliosis[J].Spine Deform,2015,3(3):233-238.DOI:10.1016/j.jspd.2014.10.001.
12 Alassaf N,Anne Tabard-Fougère,Dayer R.Casting in infantile idiopathic scoliosis as a temporising measure:A systematic review and meta-analysis[J].SAGE Open Med,2020.DOI:10.1177/2050312120925339.
13 Mahajan R,Kishan S,Mallepally AR,et al.Evolution of casting techniques in early-onset and congenital scoliosis[J].J Clin Orthop Trauma,2020,11(5):810-815.DOI:10.1016/j.jcot.2020.06.034.
14 Hardesty CK,Huang RP,Ron EH,et al.Early-Onset Scoliosis:Updated Treatment Techniques and Results[J].Spine Deform,2018,6(4):467.DOI:10.1016/j.jspd.2017.12.012.
15 Iorio J,Orlando G,Diefenbach C,et al.Serial Casting for Infantile Idiopathic Scoliosis:Radiographic Outcomes and Factors Associated With Response to Treatment[J].J Pediatr Orthop,2017,37(5):311-316.DOI:10.1097/BPO.0000000000000654.
16 Baulesh DM,Huh J,Judkins T,et al.The Role of Serial Casting in Early-onset Scoliosis (EOS)[J].J Pediatr Orthop,2012,32(7):658-663.DOI:10.1097/BPO.0b013e318269c438.
17 Fletcher ND,McClung A,Rathjen KE,et al.Serial Casting as a Delay Tactic in the Treatment of Moderate-to-Severe Early-onset Scoliosis[J].J Pediatr Orthop,2012,32(7):664.DOI:10.1097/BPO.0b013e31824bdb55.
18 Cameron M,Welborn,Jacques,et al.Infantile Idiopathic Scoliosis:Factors Affecting EDF Casting Success[J].Spine deform,2018,6(5):614-620.DOI:10.1016/j.jspd.2018.01.007.
19 Negrini S,Minozzi S,Bettany-Saltikov J,et al.Braces for idiopathic scoliosis in adolescents[J].Cochrane Database Syst Rev,2015,18(6):CD006850.DOI:10.1002/14651858.CD006850.
20 Lenke LG,Dobbs MB.Management of juvenile idiopathic scoliosis[J].J Bone Joint Surg Am Vol,2007,89(Suppl 1)(1):55-63.DOI:10.2106/JBJS.F.00644.
21 Weiss HR,Nan XF,Moramarco M,et al.Bracing Scoliosis-State of the Art (Mini-Review)[J].Curr Pediatr Rev,2016,12(1):36-42.DOI:10.2174/1573396312666151117120905.
22 张秀英,王克来,张连海,等.矫形支具在先天性脊柱侧凸治疗中的应用[J].中国矫形外科杂志,2012,20(8):711-713,768.DOI:10.3977/j.issn.1005-8478.2012.08.11.Zhang XY,Wang KL,Zhang LM,et al.The application of orthopedic brace in congenital scoliosis[J].Orthop J China,2012,20(8):711-713,768.DOI:10.3977/j.issn.1005-8478.2012.08.11.
23 Gomez JA,Hresko MT,Glotzbecker MP.Nonsurgical Management of Adolescent Idiopathic Scoliosis[J].J Am Acad Orthop Surg,2016,24(8):555-564.DOI:10.5435/JAAOS-D-14-00416.
24 Kaelin AJ.Adolescent idiopathic scoliosis:indications for bracing and conservative treatments[J].Ann Transl Med,2020,8(2):28.DOI:10.21037/atm.2019.09.69.
25 Pahys JM,Guille JT.What’s New in Congenital Scoliosis?[J].J Pediatr Orthop,2018,38(3):e172-e179.DOI:10.1097/BPO.0000000000000922.
26 Kaspiris A,Grivas TB,Weiss HR,et al.Surgical and conservative treatment of patients with congenital scoliosis:a search for long-term results[J].Scoliosis,2011,6(1):12.DOI:10.1186/1748-7161-6-12.
27 Brooks JT,Sponseller PD.What’s New in the Management of Neuromuscular Scoliosis[J].J Pediatr Orthop,2016,36(6):627-633.DOI:10.1097/BPO.0000000000000497.
28 Harshavardhana NS,Lonstein JE.Results of Bracing for Juvenile Idiopathic Scoliosis[J].Spine Deform,2018,6(3):201-206.DOI:10.1016/j.jspd.2017.10.009.
29 Wang Y,Feng Z,Wu Z,et al.Brace treatment can serve as a time-buying tactic for patients with congenital scoliosis[J].J Orthop Surg Res,2019,14(1):194.DOI:10.1186/s13018-019-1244-4.
30 Negrini S,Donzelli S,Aulisa AG,et al.2016 SOSORT guidelines:Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth[J].Scoliosis Spinal Disord,2018,13:3.DOI:10.1186/s13013-017-0145-8.
31 Kalichman L,Kendelker L,Bezalel T.Bracing and exercise-based treatment for idiopathic scoliosis[J].J Bodyw Mov Ther,2016,20(1):56-64.DOI:10.1016/j.jbmt.2015.04.007.
32 Berdishevsky H,Lebel VA,Bettany-Saltikov J,et al.Physiotherapy scoliosis-specific exercises-a comprehensive review of seven major schools[J].Scoliosis Spinal Disord,2016,11:20.DOI:10.1186/s13013-016-0076-9.
33 V?llner F,Dingeldey E,Schmitz S,et al.Conservative and surgical treatment of idiopathic scoliosis[J].Der Orthopade,2020,49(7):635-646.DOI:10.1007/s00132-020-03928-2.
34 Biaek M.Mild Angle Early Onset Idiopathic Scoliosis Children Avoid Progression Under FITS Method (Functional Individual Therapy of Scoliosis)[J].Medicine,2015,94(20):e863.DOI:10.1097/MD.0000000000000863.
35 周璇,杜青.脊柱侧凸特定运动疗法研究进展[J].中国康复医学杂志,2016,31(4):478-481.DOI:10.3969/j.issn.1001-1242.2016.04.025.Zhou X,Du Q.Research progress of specific exercise therapy for scoliosis[J].Chin J Rehabil Med,2016,31(4):478-481.DOI:10.3969/j.issn.1001-1242.2016.04.025.
36 Otman S,Kose N,Yakut Y.The efficacy of Schroths 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey[J].Saudi Medical Journal,2005,26(9):1429.DOI:10.1016/j.rimni.2011.07.001.
37 Grivas TB,Vasiliadis ES,Mihas C,et al.Trunk asymmetry in juveniles[J].Scoliosis,2008,3(1):13.DOI:10.1186/1748-7161-3-13.
38 Liu D,Huang S,Yu X,et al.Effects of Specific Exercise Therapy on Adolescent Patients with Idiopathic Scoliosis:A Prospective Controlled Cohort Study[J].Spine,2020,45(15):1039-1046.DOI:10.1097/BRS.0000000000003451.
39 李唐波,林涛,孟怡辰,等.术前Halo重力牵引辅助治疗青少年重度脊柱侧凸畸形的临床疗效[J].中国临床医学,2017,24(4):510-513.DOI:10.12025/j.issn.1008-6358.2017.20161218.Li TB,Lin T,Meng YC,et al.Clinical efficacy of preoperative Halo gravity traction in the treatment of severe adolescent scoliosis[J].Chin J Clin Med,2017,24(4):510-513.DOI:10.12025/j.issn.1008-6358.2017.20161218.
40 D’Astous JL,Sanders JO.Casting and Traction Treatment Methods for Scoliosis[J].Orthop Clin North Am,2007,38(4):477-484.DOI:10.1016/j.ocl.2007.03.006.
41 Yang C,Wang H,Zheng Z,et al.Halo-gravity traction in the treatment of severe spinal deformity:a systematic review and meta-analysis[J].Eur Spine J,2017,26(7):1810-1816.DOI:10.1007/s00586-016-4848-y.
42 Pourtaheri S,Shah SA,Ditro CP,et al.Preoperative halo-gravity traction with and without thoracoscopic anterior release for skeletal dysplasia patients with severe kyphoscoliosis[J].J Child Orthop,2016,10(2):135-142.DOI:10.1007/s11832-016-0721-0.
43 Garabekyan T,Hosseinzadeh P,Iwinski HJ,et al.The results of preoperative halo-gravity traction in children with severe spinal deformity[J].J Pediatr Orthop B,2014,23(1):1-5.DOI:10.1097/BPB.0b013e32836486b6.
44 朱锋,邱勇,王斌,等.Halo轮椅悬吊重力牵引在严重脊柱侧后凸儿童术前的应用价值[J].中国脊柱脊髓杂志,2010,20(7):549-553.DOI:10.3969/j.issn.1004-406X.2010.07.06.Zhu F,Qiu Y,Wang B,et al.Preoperative Halo-gravity traction in the treatment of severe pediatric scofiosis and kyphosis[J].Chin J Spine Spinal Cord,2010,20(7):549-553.DOI:10.3969/j.issn.1004-406X.2010.07.06.
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备注/Memo
收稿日期:2020-10-24。
基金项目:国家自然科学基金面上项目(编号:81972030),上海市卫生健康委员会卫生行业临床研究专项(编号:202040292),上海市卫生健康委先进适宜技术推广项目(编号:2019SY021),上海市进一步加快中医药事业发展三年行动计划(2018年-2020年)(编号:ZY(2018-2020)-FWTX-8006),上海交通大学医学院附属新华医院院级临床研究培育基金项目(编号:17CSK02)
通讯作者:杜青,Email:duqing@xinhuamed.com.cn