韩林东 李明

摘 要：特发性脊柱侧弯是一类常见的脊柱三维畸形，在青少年中发病率最高，由于病因尚未明确，故称其为特发性。该病一旦被确诊，首先要考虑的是手术或非手术治疗的选择。手术治疗虽然在短期内效果明显，但存在费用高、风险大、并发症多等缺点，在疾病早期不宜作为首选，因此早期的非手术治疗被广泛讨论。本文通过对国内外相关文献的研究，将青少年特发性脊柱侧弯非手术治疗的进展作一简单阐述。

关键词：青少年特发性脊柱侧弯；非手术治疗；手术治疗

中图分类号：R726.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.010

文章編号：1006-1959（2018）08-0028-03

Progress in Non-operative Treatment of Adolescent Idiopathic Scoliosis

HAN Lin-dong，LI Ming

（Department of Orthopaedics，Children's Hospital Affiliated to Chongqing Medical University/Ministry of Education Key Laboratory for Research on Child Developmental Diseases/State International Science and Technology Cooperation Base for Major Diseases in Children/Chongqing Key Laboratory of Pediatrics，Chongqing 400014，China）

Abstract：Idiopathic scoliosis is a common three dimensional deformity of the spine.It has the highest incidence in adolescents. Because the etiology is not yet clear，it is called idiopathic.Once the disease is diagnosed，the first consideration is the choice of surgical or non operative treatment.Although the operation is effective in the short term，it has high cost，high risk，and many complications.The early nonsurgical treatment is widely discussed in the early stage of the disease.This paper makes a brief introduction to the progress of the non operative treatment of adolescent idiopathic scoliosis through the study of relevant literature at home and abroad.

Key words：Adolescent idiopathic scoliosis；Non-surgical treatment；Surgical treatment

青少年特发性脊柱侧弯（adolescent idiopathic scoliosis，AIS）是最常见的特发性脊柱三维畸形，约占脊柱侧弯的80%，发病率为2%～3%，好发于10～16岁的女孩，Cobb角≥10°即可诊断[1]。AIS以脊柱侧凸为主，伴有椎体旋转畸形，病因及发病机制暂不明确，可能与钙调蛋白异常、褪黑素降低、神经生理学遗传缺陷、生物力学异常、遗传因素、性别差异、雌激素受体表达等有关[2，3]，这给我们的治疗带来了巨大的挑战。AIS的诊疗策略是早发现、早诊断、早干预，避免侧弯发生进展性改变，尽量保守治疗，规避手术治疗。目前，众多研究表明非手术治疗AIS的有效性的证据还不够充分[4]，我国有学者指出，AIS是一种与体内相关因素紊乱有关的临床综合征，人体有一定的代偿能力，在临床诊治中对于不影响生活质量的畸形可不做过多处理 [5]。但是，由于社会舆论的不健康导向以及人们对外在形象的高要求，外在畸形对青少年的身心健康产生了负面影响。……