Emphasizing etiology and strengthening the understanding and treatment of degenerative scoliosis
10.3760/cma.j.cn121113-20240304-00135
- VernacularTitle:重视病因，加深退行性脊柱侧凸的认识与规范治疗
- Author:
Huilin YANG
1
Author Information
1. 苏州大学附属第一医院骨科，苏州 215000
- Keywords:
Intervertebral disc degeneration;
Scoliosis;
Osteoporosis
- From:
Chinese Journal of Orthopaedics
2024;44(11):717-723
- CountryChina
- Language:Chinese
-
Abstract:
Adult scoliosis is categorized into two main types: idiopathic and degenerative. Degenerative scoliosis (DS) is the most common type of spinal deformity in adults, with a higher incidence observed in the middle-aged and elderly population. As the population ages, its incidence is increasing annually, resulting in a significant economic burden and health impact on both society and individuals. The etiology of DS is complex and closely related to several factors, including intervertebral disc degeneration, biomechanical changes, osteoporosis, and sarcopenia. The diagnosis of DS relies on clinical physical examinations and imaging, with staging systems such as SRS, Schwab's, SRS-Schwab's, Lenke-Silva, and Berjano providing criteria for its classification and treatment. The treatment of DS consists of conservative and surgical approaches. Conservative treatments, such as physical therapy and medications, are employed primarily for symptom control. However, the therapeutic effects of these treatments have not been substantiated by high-level clinical research evidence. Surgical treatment necessitates individualized planning. Minimally invasive surgical techniques offer less invasive and faster recovery treatment options but come with specific indications and contraindications. In light of the current challenges posed by the unclear etiology, limitations of minimally invasive surgery, and the necessity to differentiate surgical approaches, there is a clear need for further research into the biological mechanisms of DS, the expansion of the application of safe and effective minimally invasive techniques, and the fine-tuning of individualized treatment strategies and surgical planning to address the health and economic challenges posed by DS in the context of an aging population.
