特发性脊柱侧弯畸形的分型与治疗 ppt课件
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treated through a posterior approach. • 椎弓根螺钉的广泛使大多数AIS可以用后路治疗。
INTRODUCTION
• Adolescent idiopathic scoliosis (AIS) is a spinal condition causing deformity of the spine in 3 dimensions: the coronal, sagittal, and axial planes. AIS is defined as any curve equal to or greater than 10 in the coronal plane1,2 in patients 10 to 18 years old.3 It is a diagnosis of exclusion after congenital, neuromuscular, neural, or syndromic causes of scoliosis have been ruled out. Preoperative mag-netic resonance imaging is useful for ruling out neural causes of scoliosis, such as syringomyelia or Chiari malformation, although its use as a preop-erative screening tool is controversial.4,5 A genetic component has been described regarding the cause of AIS.6–11 With an incidence of 11% among first-degree relatives,12 it is not uncommon for a health care provider to manage multiple mem-bers of a family with scoliosis.
• 青少年特发性脊柱侧凸（AIS）可根据Lenke分类系统进行分类， 该系统包括曲线大小，柔韧性。
• The Lenke classification serves as a guide with respect to level selection in patients with AIS.
• Lenke分类可作为AIS患者融合水平选择的指南。 • The widespread use of pedicle screws has resulted in most AIS being
Neurosurg Clin N Am 24 (2013) 173–183
KEYWORDS
• Adolescent idiopathic scoliosis Lenke classification Scoliosis Pediatric spine deformity Pedicle screws
• AIS affects approximately 2% to 3% of the adolescent population, but fewer than 10% of patients with AIS need treatment.13 The higher the curve magnitude, the lower the prevalence and the higher the female/male ratio. Curves greater than 30 have a 0.1% to 0.3% prevalence and affect females 10 times more than males.
• 青少年特发性脊柱侧弯Lenke分型弓根螺钉矫形
KEY POINTS
• Adolescent idiopathic scoliosis (AIS) can be classified according to the Lenke classification system, which incorporates curve magnitude, flexibility, the lumbar modifier, and the sagittal plane.
特发性脊柱侧弯畸形的分型与治疗
Adolescent Scoliosis Classification and Treatment 特发性脊柱侧弯畸形的分型与治疗
Jane S. Hoashi, MD, MPH, Patrick J. Cahill, MD, James T. Bennett, MD, Amer F. Samdani, MD*
• 青少年特发性脊柱侧凸（AIS）是一种脊柱疾病，在三维方面引起脊柱畸形：冠状面，矢状面和轴面。 AIS被定义为10-18岁患者冠 状面等于或大于10。排除先天性，神经肌肉，神经或综合征引起的脊柱侧凸原因。 术前磁共振成像对于排除脊柱侧凸的神经原因， 如脊髓空洞症或Chiari畸形是有用的，尽管其作为术前筛查工具的使用还存在争议.已经报道了AIS的原因 .在一级亲属中，发生率为 11％，医疗保健提供者报道一个家庭有多个脊柱侧弯患者的情况并不少见。
• AIS对青春期人群的影响约为2％〜3％，而AIS患者中只有不到10％需要治 疗。曲度越重，患病率越低，女性比例越高。曲度大于30的患病率为0.1 ％〜0.3％，女性患病率是男性的10倍以上。
• For years, the King-Moe classification was the most widely used system for guiding treatment in AIS. Its shortcomings included classifying curves based only on the coronal plane and showin, only variants of the thoracic curve were described, leaving some other curve types such as thoracolumbar or lumbar curves unable to be classified by this system. The Lenke classification16 addresses these shortcomings and is now considered the gold standard for classifying AIS and guiding treatment. In this article, the Lenke classification is used to describe the AIS types and the treatment options.
INTRODUCTION
• Adolescent idiopathic scoliosis (AIS) is a spinal condition causing deformity of the spine in 3 dimensions: the coronal, sagittal, and axial planes. AIS is defined as any curve equal to or greater than 10 in the coronal plane1,2 in patients 10 to 18 years old.3 It is a diagnosis of exclusion after congenital, neuromuscular, neural, or syndromic causes of scoliosis have been ruled out. Preoperative mag-netic resonance imaging is useful for ruling out neural causes of scoliosis, such as syringomyelia or Chiari malformation, although its use as a preop-erative screening tool is controversial.4,5 A genetic component has been described regarding the cause of AIS.6–11 With an incidence of 11% among first-degree relatives,12 it is not uncommon for a health care provider to manage multiple mem-bers of a family with scoliosis.
• 青少年特发性脊柱侧凸（AIS）可根据Lenke分类系统进行分类， 该系统包括曲线大小，柔韧性。
• The Lenke classification serves as a guide with respect to level selection in patients with AIS.
• Lenke分类可作为AIS患者融合水平选择的指南。 • The widespread use of pedicle screws has resulted in most AIS being
Neurosurg Clin N Am 24 (2013) 173–183
KEYWORDS
• Adolescent idiopathic scoliosis Lenke classification Scoliosis Pediatric spine deformity Pedicle screws
• AIS affects approximately 2% to 3% of the adolescent population, but fewer than 10% of patients with AIS need treatment.13 The higher the curve magnitude, the lower the prevalence and the higher the female/male ratio. Curves greater than 30 have a 0.1% to 0.3% prevalence and affect females 10 times more than males.
• 青少年特发性脊柱侧弯Lenke分型弓根螺钉矫形
KEY POINTS
• Adolescent idiopathic scoliosis (AIS) can be classified according to the Lenke classification system, which incorporates curve magnitude, flexibility, the lumbar modifier, and the sagittal plane.
特发性脊柱侧弯畸形的分型与治疗
Adolescent Scoliosis Classification and Treatment 特发性脊柱侧弯畸形的分型与治疗
Jane S. Hoashi, MD, MPH, Patrick J. Cahill, MD, James T. Bennett, MD, Amer F. Samdani, MD*
• 青少年特发性脊柱侧凸（AIS）是一种脊柱疾病，在三维方面引起脊柱畸形：冠状面，矢状面和轴面。 AIS被定义为10-18岁患者冠 状面等于或大于10。排除先天性，神经肌肉，神经或综合征引起的脊柱侧凸原因。 术前磁共振成像对于排除脊柱侧凸的神经原因， 如脊髓空洞症或Chiari畸形是有用的，尽管其作为术前筛查工具的使用还存在争议.已经报道了AIS的原因 .在一级亲属中，发生率为 11％，医疗保健提供者报道一个家庭有多个脊柱侧弯患者的情况并不少见。
• AIS对青春期人群的影响约为2％〜3％，而AIS患者中只有不到10％需要治 疗。曲度越重，患病率越低，女性比例越高。曲度大于30的患病率为0.1 ％〜0.3％，女性患病率是男性的10倍以上。
• For years, the King-Moe classification was the most widely used system for guiding treatment in AIS. Its shortcomings included classifying curves based only on the coronal plane and showin, only variants of the thoracic curve were described, leaving some other curve types such as thoracolumbar or lumbar curves unable to be classified by this system. The Lenke classification16 addresses these shortcomings and is now considered the gold standard for classifying AIS and guiding treatment. In this article, the Lenke classification is used to describe the AIS types and the treatment options.