少年脊柱侧弯

少年脊柱侧弯通常是指在4-10岁中首次诊断为脊柱侧弯的患儿。这类型包含了所有脊柱侧弯中的10% - 15%。这分类的低龄患者之中,男孩比例稍高于女孩,而弯曲常是左侧弯;这分类的高龄患者中与青少年特发性侧弯较为相似,女孩的比例较高且常为右侧弯。

评估

正如婴幼儿脊柱侧弯中所描述的,您的小儿脊柱儿科医生可能会安排MRI检查,这个决定于侧弯的程度、体格检查所发现的问题以及X光检查的结果。大约20%小于10岁的患儿而侧弯大于20º则有可能潜在脊髓的病变,尤其是Arnold-Chiari畸形(脑干下移)、脊髓空洞症伴随少年脊柱侧弯的发病率较高,这种情况可以通过脊柱全长MRI检查发现 (圖一)。如果MRI发现引起患儿侧弯的病因,您的医生就会建议您转往小儿神经外科医生就诊。有时神经外科手术后可以帮助矫正侧弯。


图1. 侧位MRI显示7岁有30°侧弯男孩的脊髓空洞

预后

少年脊柱侧弯达至30°而没有得到治疗, 便有继续恶化的趋势。支具常用于控制弯曲恶化,但几乎95%的少年患儿侧弯度数會继续加大并需要外科手术治疗。

The Scoliosis Research Society provides information on these web pages regarding research and links as a public service. The SRS believes that patients should contact their treating physician about the relevance of any information listed on the site prior to proceeding with any particular treatment. Just as no two individuals are exactly alike, no two patients with a spinal deformity are the same. Therefore, your spinal deformity surgeon will be the most important source of information about the management of your particular spinal problem.