What is scoliosis?

脊椎是由一堆叫做椎骨的长方形积木组成的. When viewed from behind, the spine normally appears straight. However, 脊柱侧凸是弯曲的，通常呈S或C形，伴有椎体的旋转. 这种弧度给人一种人向一侧倾斜的感觉.

脊柱侧弯是指脊柱的弯曲度为10度或更大 X-ray. 脊柱侧凸引起的脊柱弯曲可能发生在脊柱的右侧或左侧, or on both sides in different sections. 胸椎(中)和腰椎(下)都可能受到脊柱侧凸的影响. Scoliosis is a type of spinal deformity.

In more than 80 percent of cases, 脊柱侧凸的病因尚不清楚，这种情况被称为特发性脊柱侧凸. 在其他情况下，脊柱侧凸可能发展为椎间盘退变的结果，如图所示 arthritis, osteoporosis or as a hereditary condition that tends to run in families.

What are the different types of scoliosis?

Congenital Scoliosis

在先天性脊柱侧凸中，由于椎骨畸形导致脊柱弯曲. 先天性脊柱侧凸的诊断可以在婴儿期早期，如果有外部迹象, but many cases are diagnosed later in childhood.

随着孩子的成长，脊柱侧凸可能会恶化，身体可能会出现不对称. 通常，先天性脊柱侧凸的治疗采用“观察和等待”的方法. 只有当弯曲明显恶化，孩子面临持续畸形和未来疼痛的风险时，才考虑手术.

Idiopathic Scoliosis

Doctors, 几十年来，护士和科学家一直在研究脊柱侧凸的自然历史和遗传学, but to this day, the cause of idiopathic scoliosis is still unknown. 但是我们知道特发性脊柱侧凸最常见的发病时间是在青春期, or around the age of 10. We also know that growth can make it worse, 我们最应该关注的是脊柱侧凸发生在发育还很长的孩子身上.

当诊断为2岁或更小的儿童时，这种类型的脊柱侧凸被称为 infantile idiopathic scoliosis.

Neuromuscular Scoliosis

患有潜在神经肌肉疾病的儿童患脊柱侧凸的风险更高. 笔直的脊柱需要正常的肌肉平衡和躯干的力量. In conditions such as cerebral palsy, spina bifida and muscular dystrophy，肌肉往往是无力和不平衡，导致脊柱弯曲的发展.

患有神经肌肉性脊柱侧凸的儿童可以选择佩戴脊柱侧凸支架，以减缓或防止病情恶化. 当曲线达到50度的临界点时，可以进行手术干预. 随着时间的推移，这些曲线将继续恶化，导致躯干逐渐不平衡. 超过80华氏度，随着肺部空间的减少，呼吸会出现困难.

What are the symptoms of scoliosis?

The following are the most common symptoms of scoliosis. However, each individual may experience symptoms differently. Symptoms may include:

• Difference in shoulder height

• The head isn't centered with the rest of the body

• Difference in hip height or position

• Difference in shoulder blade height or position

• 当站直时，不同的是手臂悬挂在身体旁边的方式

• 推荐十大正规网赌平台弯曲时，背部两侧的高度不同

• 从前面或后面看肋骨的突出或不对称

脊柱侧凸的症状可能类似于其他脊柱疾病或畸形, or may be a result of an injury or infection. Always consult your doctor for a diagnosis.

通常与特发性脊柱侧凸不相关的症状是背痛, leg pain, and changes in bowel and bladder habits. If a person is experiencing these types of symptoms, 他或她需要医生立即进行进一步的医学评估，以确定症状的原因.

How is scoliosis diagnosed?

早期发现脊柱侧凸是成功治疗的关键. 除了完整的病史和体格检查外，还有 X-ray is the primary diagnostic tool for scoliosis. In establishing a diagnosis of scoliosis, 医生在x光片上测量脊柱弯曲的程度.

以下附加的诊断程序可用于非特发性曲率, atypical curve patterns or congenital scoliosis:

• MRI. 这种诊断程序使用大型磁铁和计算机的组合来产生体内器官和结构的详细图像.

• CT scan. 这种诊断成像程序使用x射线和计算机技术相结合来产生水平, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays.

How is scoliosis treated?

治疗的目标是阻止弯曲的进展和防止畸形. 观察和反复检查——也被称为“观察和等待”的方法——可能需要确定脊柱是否继续弯曲. 当一个人的曲线小于20度并且还在增长时，就可以使用这种方法.

对于脊柱侧凸曲线在20 - 50度之间的生长期儿童, bracing is recommended. 外部躯干支架，或TLSO，佩戴规定的时间. The brace applies corrective pressure to the growing spine, preventing further worsening of the scoliosis.

对于患有严重脊柱侧凸或脊柱弯曲恶化至50度以上的儿童，手术是推荐的治疗选择. At the Johns Hopkins Children’s Center, our team of pediatric spine surgeons, 护士和麻醉师使用以家庭为中心的方法来制定照顾孩子的计划. We are a high-volume scoliosis center, 我们不断学习和采用脊柱侧凸患儿手术和术后护理的最佳做法.