Abstract：
The goal of this study is to discuss the transitional nature of idiopathic scoliosis and the variation in treatment and management across the spectrum of age presentation.
This is a review article that discusses the evaluation, management, and classification of idiopathic scoliosis. The authors searched PubMed/MEDLINE, Google Scholar, and the Cochrane database for articles published up to April 2024. Keywords and MeSH terms relevant to the topic were used, including adolescent idiopathic scoliosis (AIS), adult idiopathic scoliosis (AdIS), adult degenerative scoliosis, young adult idiopathic scoliosis, early-onset scoliosis (EOS), classification, management, follow-up, outcomes, natural history, Cobb angle, and transitional care. Reference lists of selected articles were also searched to identify further articles. Inclusion criteria included English language articles that summarized any type of study design, including randomized controlled trials, observational studies, case-control/series, or metaanalysis, with study populations ranging from infants to > 50-year-old patients. Inter-reviewer disagreement on inclusion of particular articles was resolved through discussion. Related information was analyzed, and relevant concepts related to the transitional period dilemma have been discussed.
Each idiopathic scoliosis case needs independent assessment with regard to the age, degree of the curve, and patient-specific presentation. An accurate prediction of the curve progression by considering the patient\'s remaining growth potential is paramount to the treatment strategy. The classification system for EOS, AIS Lenke classification, AdIS classification, and the Scoliosis Research Society-Schwab classification are important for reliable communication between surgeons treating deformities. Untreated progressive idiopathic scoliosis warrants multidisciplinary management during the transition from EOS stage to AIS and then to AdIS. Also, surgical treatment of untreated AIS transitioning to AdIS is specific and nuanced. AdIS needs to be differentiated from adult degenerative scoliosis because the latter is associated with multiple comorbidities and anatomical differences.
Idiopathic scoliosis presents across the age spectrum with specific age-related decisions that transition into adulthood. Integrated models of both surgical and nonsurgical treatment of idiopathic scoliosis are warranted.
This is a review article that discusses the evaluation, management, and classification of idiopathic scoliosis. The authors searched PubMed/MEDLINE, Google Scholar, and the Cochrane database for articles published up to April 2024. Keywords and MeSH terms relevant to the topic were used, including adolescent idiopathic scoliosis (AIS), adult idiopathic scoliosis (AdIS), adult degenerative scoliosis, young adult idiopathic scoliosis, early-onset scoliosis (EOS), classification, management, follow-up, outcomes, natural history, Cobb angle, and transitional care. Reference lists of selected articles were also searched to identify further articles. Inclusion criteria included English language articles that summarized any type of study design, including randomized controlled trials, observational studies, case-control/series, or metaanalysis, with study populations ranging from infants to > 50-year-old patients. Inter-reviewer disagreement on inclusion of particular articles was resolved through discussion. Related information was analyzed, and relevant concepts related to the transitional period dilemma have been discussed.
Each idiopathic scoliosis case needs independent assessment with regard to the age, degree of the curve, and patient-specific presentation. An accurate prediction of the curve progression by considering the patient\'s remaining growth potential is paramount to the treatment strategy. The classification system for EOS, AIS Lenke classification, AdIS classification, and the Scoliosis Research Society-Schwab classification are important for reliable communication between surgeons treating deformities. Untreated progressive idiopathic scoliosis warrants multidisciplinary management during the transition from EOS stage to AIS and then to AdIS. Also, surgical treatment of untreated AIS transitioning to AdIS is specific and nuanced. AdIS needs to be differentiated from adult degenerative scoliosis because the latter is associated with multiple comorbidities and anatomical differences.
Idiopathic scoliosis presents across the age spectrum with specific age-related decisions that transition into adulthood. Integrated models of both surgical and nonsurgical treatment of idiopathic scoliosis are warranted.
摘要：
这项研究的目的是讨论特发性脊柱侧凸的过渡性以及年龄分布范围内的治疗和管理变化。
这是一篇评论文章，讨论了评估，管理,特发性脊柱侧凸的分类。作者搜索PubMed/MEDLINE，谷歌学者，以及Cochrane数据库中截至2024年4月发表的文章。使用了与主题相关的关键词和MeSH术语，包括青少年特发性脊柱侧凸（AIS），成人特发性脊柱侧凸（AdIS），成人退行性脊柱侧凸，年轻成人特发性脊柱侧凸，早发性脊柱侧凸（EOS），分类，管理,后续行动,结果，自然史,Cobb角,过渡护理。还搜索了选定文章的参考列表以识别更多文章。纳入标准包括总结任何类型的研究设计的英语文章，包括随机对照试验,观察性研究，病例控制/系列，或元分析，研究人群从婴儿到>50岁的患者。通过讨论解决了审稿人对列入特定条款的分歧。相关信息进行了分析，并对过渡时期困境的相关概念进行了讨论。
每个特发性脊柱侧凸病例都需要对年龄进行独立评估，曲线的程度，和患者特定的演示。通过考虑患者的剩余生长潜力来准确预测曲线进展对治疗策略至关重要。EOS的分类系统，AIS伦克分类，AdIS分类，脊柱侧弯研究协会-施瓦布分类对于治疗畸形的外科医生之间的可靠沟通很重要。未经治疗的进行性特发性脊柱侧凸需要在从EOS阶段过渡到AIS然后过渡到AdIS的过程中进行多学科管理。此外，未经治疗的AIS过渡到AdIS的手术治疗是具体和细微差别的。AdIS需要与成人退行性脊柱侧凸区分开来，因为后者与多种合并症和解剖学差异有关。
特发性脊柱侧凸在整个年龄段表现出特定的与年龄相关的决定，这些决定过渡到成年期。特发性脊柱侧凸的手术和非手术治疗的综合模型是必要的。
这是一篇评论文章，讨论了评估，管理,特发性脊柱侧凸的分类。作者搜索PubMed/MEDLINE，谷歌学者，以及Cochrane数据库中截至2024年4月发表的文章。使用了与主题相关的关键词和MeSH术语，包括青少年特发性脊柱侧凸（AIS），成人特发性脊柱侧凸（AdIS），成人退行性脊柱侧凸，年轻成人特发性脊柱侧凸，早发性脊柱侧凸（EOS），分类，管理,后续行动,结果，自然史,Cobb角,过渡护理。还搜索了选定文章的参考列表以识别更多文章。纳入标准包括总结任何类型的研究设计的英语文章，包括随机对照试验,观察性研究，病例控制/系列，或元分析，研究人群从婴儿到>50岁的患者。通过讨论解决了审稿人对列入特定条款的分歧。相关信息进行了分析，并对过渡时期困境的相关概念进行了讨论。
每个特发性脊柱侧凸病例都需要对年龄进行独立评估，曲线的程度，和患者特定的演示。通过考虑患者的剩余生长潜力来准确预测曲线进展对治疗策略至关重要。EOS的分类系统，AIS伦克分类，AdIS分类，脊柱侧弯研究协会-施瓦布分类对于治疗畸形的外科医生之间的可靠沟通很重要。未经治疗的进行性特发性脊柱侧凸需要在从EOS阶段过渡到AIS然后过渡到AdIS的过程中进行多学科管理。此外，未经治疗的AIS过渡到AdIS的手术治疗是具体和细微差别的。AdIS需要与成人退行性脊柱侧凸区分开来，因为后者与多种合并症和解剖学差异有关。
特发性脊柱侧凸在整个年龄段表现出特定的与年龄相关的决定，这些决定过渡到成年期。特发性脊柱侧凸的手术和非手术治疗的综合模型是必要的。
