Orthopaedics and Trauma最新文献

英文中文

The use of neurophysiology in spinal surgery: who, what, when and how? 神经生理学在脊柱外科中的应用：谁、什么、何时、如何？

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.011

Jamie MacDonald, Athanasios I Tsirikos

The use of neurophysiology has been widely accepted as standard of care and a prerequisite in order to safely proceed with complex spinal surgery. This increases the safety against the existing risk of neurological damage that can occur when spinal deformity correction or major neurosurgical treatment is performed. The techniques of intraoperative neuromonitoring have progressed significantly with the use of multimodal somatosensory and motor recordings increasing the reliability and efficacy in detecting neural events. The ability of the surgical, neurophysiology and anaesthetic teams to work in good coordination and with a clear treatment plan reduces considerably the frequency of false monitoring events, as well as the incidence of major neurological complications. The role of neurophysiology extends to include preoperative diagnostic testing that can facilitate detection of neural abnormalities that would affect spinal surgery. In addition, postoperative neurophysiology can be extremely useful when the patient sustained a neurological deficit and close monitoring of the functional recovery is required. This can also assist making the decision regarding the timing to return to surgery if the index procedure had to be abandoned due to an irreversible intraoperative neuromonitoring event. This review explores the use of neurophysiology and its available modalities in complex spinal surgery.

神经生理学的应用已被广泛接受为安全进行复杂脊柱手术的标准护理和先决条件。这增加了安全性，避免了脊柱畸形矫正或主要神经外科治疗时可能发生的神经损伤风险。术中神经监测技术随着多模态体感和运动记录的使用取得了显著进展，增加了检测神经事件的可靠性和有效性。外科、神经生理学和麻醉小组的良好协调能力和明确的治疗计划大大减少了错误监测事件的频率，以及主要神经系统并发症的发生率。神经生理学的作用扩展到包括术前诊断测试，可以促进检测可能影响脊柱手术的神经异常。此外，术后神经生理学在患者持续神经功能缺损和需要密切监测功能恢复时非常有用。如果由于不可逆转的术中神经监测事件而不得不放弃手术，这也有助于决定何时恢复手术。这篇综述探讨了神经生理学及其在复杂脊柱手术中的应用。

{"title":"The use of neurophysiology in spinal surgery: who, what, when and how?","authors":"Jamie MacDonald, Athanasios I Tsirikos","doi":"10.1016/j.mporth.2025.09.011","DOIUrl":"10.1016/j.mporth.2025.09.011","url":null,"abstract":"<div><div>The use of neurophysiology has been widely accepted as standard of care and a prerequisite in order to safely proceed with complex spinal surgery. This increases the safety against the existing risk of neurological damage that can occur when spinal deformity correction or major neurosurgical treatment is performed. The techniques of intraoperative neuromonitoring have progressed significantly with the use of multimodal somatosensory and motor recordings increasing the reliability and efficacy in detecting neural events. The ability of the surgical, neurophysiology and anaesthetic teams to work in good coordination and with a clear treatment plan reduces considerably the frequency of false monitoring events, as well as the incidence of major neurological complications. The role of neurophysiology extends to include preoperative diagnostic testing that can facilitate detection of neural abnormalities that would affect spinal surgery. In addition, postoperative neurophysiology can be extremely useful when the patient sustained a neurological deficit and close monitoring of the functional recovery is required. This can also assist making the decision regarding the timing to return to surgery if the index procedure had to be abandoned due to an irreversible intraoperative neuromonitoring event. This review explores the use of neurophysiology and its available modalities in complex spinal surgery.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 6","pages":"Pages 412-423"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Congenital spinal deformity: aetiology, classification and associated anomalies 先天性脊柱畸形：病因、分类和相关异常

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.002

Simon B Roberts, Athanasios I Tsirikos

Congenital spinal deformities arise from congenital anomalies that impact one or more vertebrae, leading to asymmetrical vertical growth of the spine, with the curvature worsening as skeletal development progresses. In Part 1 of this review, the aetiology, classification and anomalies associated with the congenital spinal deformity are discussed. Congenital vertebral anomalies manifest during the embryonic phase of spinal development and can be categorized into failures of formation, segmentation, or mixed anomalies. Timely identification of the specific vertebral anomaly is crucial for predicting prognosis of the deformity and initiating treatment prior to the onset of a severe curvature. Factors such as the anatomy, location, and number of abnormalities, along with their relation to surrounding spinal structures, influence the likelihood of deformity progression. In Part 2 of this review, the evaluation of patients presenting with congenital spinal deformity, necessary investigations, as well as conservative and surgical treatment strategies are discussed.

先天性脊柱畸形是由先天畸形影响一个或多个椎骨引起的，导致脊柱垂直生长不对称，随着骨骼发育的进展，弯曲度恶化。在这篇综述的第一部分，我们将讨论先天性脊柱畸形的病因、分类和异常。先天性椎体畸形在脊柱发育的胚胎阶段表现出来，可分为形成失败、分割失败或混合性异常。及时识别特定的椎体异常对于预测畸形的预后和在严重弯曲发生之前开始治疗至关重要。诸如解剖结构、位置和畸形数量等因素，以及它们与周围脊柱结构的关系，都会影响畸形进展的可能性。在本综述的第2部分中，我们将讨论先天性脊柱畸形患者的评估、必要的检查以及保守和手术治疗策略。

引用次数: 0

The development of scoliosis in association with syndromic conditions: how to assess patients and decide on treatment 与综合征相关的脊柱侧凸的发展：如何评估患者并决定治疗

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.012

Maryem-Fama Ismael Aguirre, Athanasios I Tsirikos

The aim of this review is to report on the diagnosis, treatment guidelines and main syndromic/genetic conditions that are related with the development of scoliosis, as well as their management. Syndromes associated with scoliosis include connective tissue disorders, conditions related to the altered rat sarcoma viral oncogene/mitogen/activated protein kinase pathway or RASopathies, skeletal dysplasias and other pathologies often related to low muscle tone. Ehlers–Danlos syndrome, osteogenesis imperfecta, Marfan syndrome, neurofibromatosis, Noonan syndrome, achondroplasia, mucopolysaccharidoses, Down syndrome, Prader–Willi syndrome, and DiGeorge syndrome are all conditions commonly associated with scoliosis. Syndromic scoliosis is, therefore, an umbrella term that encompasses several different pathologies that display scoliosis, as well as other musculoskeletal or systemic features. Scoliosis patterns in syndromic patients can share traits with idiopathic scoliosis but are more often dystrophic or atypical with characteristics secondary to loss of muscle tone, joint laxity, and tumour formation. Treatments include observation, bracing or surgical correction in the more severe cases. Surgical technique in syndromic scoliosis in the past few years has followed similar trends to adolescent idiopathic scoliosis with a tendency to favour one stage posterior spinal fusion based on pedicle screw segmental correction and fixation. The treatment of syndromic scoliosis is often made more challenging due to the presence of co-morbidities and the consequent higher risk of perioperative complications when compared to patients with adolescent idiopathic scoliosis. Management of this rare and diverse group of pathologies requires a multidisciplinary approach in a specialized spinal unit. Complications following surgical correction of syndromic scoliosis share common trends such as neurological damage, increased infection rates and non-union, although each syndrome presents specific issues.

本综述的目的是报道与脊柱侧凸发展相关的诊断、治疗指南和主要综合征/遗传条件及其管理。与脊柱侧凸相关的综合征包括结缔组织疾病、与大鼠肉瘤病毒癌基因/有丝分裂原/活化蛋白激酶途径改变或ras病变相关的病症、骨骼发育不良和其他通常与低肌张力相关的病理。Ehlers-Danlos综合征、成骨不全症、Marfan综合征、神经纤维瘤病、Noonan综合征、软骨发育不全症、粘多糖病、唐氏综合征、prder - willi综合征和DiGeorge综合征都是脊柱侧凸的常见症状。因此，综合征性脊柱侧凸是一个总括性术语，包括几种不同的病理，显示脊柱侧凸，以及其他肌肉骨骼或系统特征。综合征患者的脊柱侧凸模式可与特发性脊柱侧凸具有相同的特征，但更常见的是营养不良或非典型性，其特征继发于肌肉张力丧失、关节松弛和肿瘤形成。治疗方法包括观察、支具或对较严重的病例进行手术矫正。在过去的几年中，综合征型脊柱侧凸的手术技术与青少年特发性脊柱侧凸有相似的趋势，倾向于基于椎弓根螺钉节段矫正和固定的一期后路脊柱融合。与青少年特发性脊柱侧凸患者相比，由于合并症的存在以及随之而来的围手术期并发症的高风险，综合征性脊柱侧凸的治疗往往更具挑战性。这种罕见和多样化的病理组的管理需要一个多学科的方法在一个专门的脊柱单位。综合征型脊柱侧凸手术矫正后的并发症有共同的趋势，如神经损伤、感染率增加和不愈合，尽管每种综合征都有其特定的问题。

{"title":"The development of scoliosis in association with syndromic conditions: how to assess patients and decide on treatment","authors":"Maryem-Fama Ismael Aguirre, Athanasios I Tsirikos","doi":"10.1016/j.mporth.2025.09.012","DOIUrl":"10.1016/j.mporth.2025.09.012","url":null,"abstract":"<div><div>The aim of this review is to report on the diagnosis, treatment guidelines and main syndromic/genetic conditions that are related with the development of scoliosis, as well as their management. Syndromes associated with scoliosis include connective tissue disorders, conditions related to the altered rat sarcoma viral oncogene/mitogen/activated protein kinase pathway or RASopathies, skeletal dysplasias and other pathologies often related to low muscle tone. Ehlers–Danlos syndrome, osteogenesis imperfecta, Marfan syndrome, neurofibromatosis, Noonan syndrome, achondroplasia, mucopolysaccharidoses, Down syndrome, Prader–Willi syndrome, and DiGeorge syndrome are all conditions commonly associated with scoliosis. Syndromic scoliosis is, therefore, an umbrella term that encompasses several different pathologies that display scoliosis, as well as other musculoskeletal or systemic features. Scoliosis patterns in syndromic patients can share traits with idiopathic scoliosis but are more often dystrophic or atypical with characteristics secondary to loss of muscle tone, joint laxity, and tumour formation. Treatments include observation, bracing or surgical correction in the more severe cases. Surgical technique in syndromic scoliosis in the past few years has followed similar trends to adolescent idiopathic scoliosis with a tendency to favour one stage posterior spinal fusion based on pedicle screw segmental correction and fixation. The treatment of syndromic scoliosis is often made more challenging due to the presence of co-morbidities and the consequent higher risk of perioperative complications when compared to patients with adolescent idiopathic scoliosis. Management of this rare and diverse group of pathologies requires a multidisciplinary approach in a specialized spinal unit. Complications following surgical correction of syndromic scoliosis share common trends such as neurological damage, increased infection rates and non-union, although each syndrome presents specific issues.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 6","pages":"Pages 424-433"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of a patient presenting with neck pain 以颈部疼痛为表现的患者评估

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.007

Gabriel Metcalf-Cuenca, Phillip Copley, Sadaquate Khan

Neck pain is a common presenting complaint to both primary and secondary care. Although the majority of cases are due to benign causes, there are several sinister pathologies that healthcare practitioners should know, and be mindful of when assessing patients. In the acute setting, cervical trauma is the most common cause and a systematic assessment is essential to ensure spinal injuries are not missed and can be appropriately managed. In non-traumatic presentations, screening for red flags allows identification of risk factors for sinister underlying pathology to prompt further investigation. Cervical spinal disease can result in life-changing neurological impairment and in certain cases, prompt treatment is indicated. The most common imaging modalities for investigating neck pain are magnetic resonance imaging (MRI), computed tomography (CT) and plain X-rays. Each has their own advantages and disadvantages, and it is important for healthcare practitioners to be aware of when the use of one over the other is indicated.

颈部疼痛是初级和二级保健的常见主诉。虽然大多数病例是由于良性的原因，有一些险恶的病理，医疗从业人员应该知道，并注意评估患者时。在急性情况下，颈椎外伤是最常见的原因，系统的评估是必不可少的，以确保脊柱损伤不被遗漏，并能得到适当的管理。在非创伤性表现中，筛查危险信号可以识别潜在病理的危险因素，从而促进进一步的调查。颈椎疾病可导致改变生活的神经损伤，在某些情况下，需要及时治疗。研究颈部疼痛最常见的成像方式是磁共振成像（MRI）、计算机断层扫描（CT）和平面x射线。每一种都有自己的优点和缺点，对于医疗保健从业人员来说，重要的是要意识到何时使用一种而不是另一种。

引用次数: 0

How to investigate a patient with lumbar back pain with or without neurological symptoms 如何调查有或无神经系统症状的腰背痛患者

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.008

Katie A Hoban, Himanshu Shekhar, Andreas K Demetriades

Lumbar back pain is responsible for a significant proportion of presentations to orthopaedic surgeons. Taking a succinct clinical history, performing a detailed examination and ordering appropriate investigations are crucial to diagnose the patient with lumbar back pain and guide subsequent management. This article aims to give an overview of the pathology, differential diagnoses, investigations and management strategies.

腰背部疼痛是骨科医生的主要症状。获取简明的临床病史，进行详细的检查并进行适当的调查对于诊断腰背痛患者并指导后续治疗至关重要。本文就该病的病理、鉴别诊断、调查及治疗策略作一综述。

引用次数: 0

Answers to the CME questions on Principles of Orthopaedics 关于骨科原理的CME问题解答

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.013

引用次数: 0

A review of spine infections: aetiology, diagnosis and management 脊柱感染的病因、诊断和治疗综述

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.009

Vibhor Abrol, Kaustubh Ahuja, Athanasios I Tsirikos

Spinal infections (SIs) are uncommon yet serious conditions involving the vertebrae, intervertebral discs, and surrounding soft tissues. They may arise via haematogenous dissemination, direct inoculation from surgical procedures or trauma, or contiguous spread from adjacent infections. The clinical presentation is often non-specific, leading to delayed diagnosis and increased risk of neurological deficits. Pyogenic and tuberculous infections remain the most common forms, each with distinct epidemiological, clinical, and radiological profiles. Accurate diagnosis relies on a combination of elevated inflammatory markers, microbiological cultures, histopathology and imaging. MRI remains the gold standard for early detection, while fluorodeoxyglucose positron emission tomography and CT-guided biopsies enhance diagnostic accuracy in equivocal cases. Differentiating tubercular from pyogenic spondylodiscitis is crucial, as treatment protocols differ significantly. Management is typically conservative in the early stages, involving pathogen-directed antimicrobial therapy and spinal bracing. Surgical intervention is indicated for patients with progressive neurological deficits, instability, severe deformity, or lack of response to medical therapy. Advances in spinal instrumentation and minimally invasive techniques have expanded the surgical options, improving functional outcomes and deformity correction. Special attention is given to anterior column reconstruction in cases of extensive vertebral destruction, particularly in spinal tuberculosis. A multidisciplinary, timely, and aetiology specific approach is essential to optimize outcomes and minimize complications. This review synthesizes current evidence to guide clinicians in the effective diagnosis and management of spinal infections.

脊柱感染是一种罕见但严重的疾病，涉及椎骨、椎间盘和周围软组织。它们可能通过血液传播、外科手术或创伤的直接接种或邻近感染的连续传播而产生。临床表现通常是非特异性的，导致诊断延迟和神经功能障碍的风险增加。化脓性和结核性感染仍然是最常见的形式，每种感染都有不同的流行病学、临床和放射学特征。准确的诊断依赖于炎症标志物升高、微生物培养、组织病理学和影像学的结合。MRI仍然是早期检测的金标准，而氟脱氧葡萄糖正电子发射断层扫描和ct引导下的活检可提高模棱两可病例的诊断准确性。鉴别结核性和化脓性脊柱炎是至关重要的，因为治疗方案有很大的不同。治疗在早期阶段通常是保守的，包括病原体导向的抗菌治疗和脊柱支撑。手术干预适用于进行性神经功能缺损、不稳定、严重畸形或对药物治疗缺乏反应的患者。脊柱内固定和微创技术的进步扩大了手术选择，改善了功能预后和畸形矫正。特别注意的是，在广泛的椎体破坏，特别是脊柱结核的情况下，前柱重建。多学科、及时和病因特异性的方法对于优化结果和减少并发症至关重要。本综述综合了目前的证据，以指导临床医生有效地诊断和管理脊柱感染。

{"title":"A review of spine infections: aetiology, diagnosis and management","authors":"Vibhor Abrol, Kaustubh Ahuja, Athanasios I Tsirikos","doi":"10.1016/j.mporth.2025.09.009","DOIUrl":"10.1016/j.mporth.2025.09.009","url":null,"abstract":"<div><div>Spinal infections (SIs) are uncommon yet serious conditions involving the vertebrae, intervertebral discs, and surrounding soft tissues. They may arise via haematogenous dissemination, direct inoculation from surgical procedures or trauma, or contiguous spread from adjacent infections. The clinical presentation is often non-specific, leading to delayed diagnosis and increased risk of neurological deficits. Pyogenic and tuberculous infections remain the most common forms, each with distinct epidemiological, clinical, and radiological profiles. Accurate diagnosis relies on a combination of elevated inflammatory markers, microbiological cultures, histopathology and imaging. MRI remains the gold standard for early detection, while fluorodeoxyglucose positron emission tomography and CT-guided biopsies enhance diagnostic accuracy in equivocal cases. Differentiating tubercular from pyogenic spondylodiscitis is crucial, as treatment protocols differ significantly. Management is typically conservative in the early stages, involving pathogen-directed antimicrobial therapy and spinal bracing. Surgical intervention is indicated for patients with progressive neurological deficits, instability, severe deformity, or lack of response to medical therapy. Advances in spinal instrumentation and minimally invasive techniques have expanded the surgical options, improving functional outcomes and deformity correction. Special attention is given to anterior column reconstruction in cases of extensive vertebral destruction, particularly in spinal tuberculosis. A multidisciplinary, timely, and aetiology specific approach is essential to optimize outcomes and minimize complications. This review synthesizes current evidence to guide clinicians in the effective diagnosis and management of spinal infections.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 6","pages":"Pages 387-401"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neuromuscular scoliosis: the why and the how of diagnosis and treatment 神经肌肉性脊柱侧凸：诊断和治疗的原因和方法

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.010

Adam P Lloyd, Adrian Gardner, Athanasios I Tsirikos

The advent of spinal deformity is a common musculoskeletal co-morbidity in patients with an underlying neuromuscular pathology. The implications of a spinal deformity in this frequently physiologically challenged patient population can be profound, with significant limitations to global function, quality of life and provision of basic nursing needs. The vast number of underlying conditions and variable severity of overall disability in which a neuromuscular spinal deformity can be encountered necessitates a personalized approach to management with multidisciplinary input. Given the heterogeneity and relative rarity of implicated pathologies, some generalization of principles in surgical management is inevitable, though the array of potential management techniques and technologies is ever increasing. The aims of this work are to provide a contemporary overview of current concepts in assessment and management common to all aetiologies of neuromuscular spinal deformity, in addition to highlighting areas of controversy and future directions.

脊柱畸形的出现是一种常见的肌肉骨骼合并症患者与潜在的神经肌肉病理。脊柱畸形对这类经常出现生理障碍的患者群体的影响可能是深远的，对整体功能、生活质量和基本护理需求的提供有重大限制。神经肌肉脊柱畸形可能会遇到大量的潜在疾病和不同程度的整体残疾，因此需要采用多学科输入的个性化方法进行管理。考虑到涉及的病理的异质性和相对罕见性，尽管潜在的管理技术和技术的阵列不断增加，但在外科治疗中一些原则的普遍化是不可避免的。这项工作的目的是提供当前概念的评估和管理共同的神经肌肉脊柱畸形的所有病因的当代概述，除了突出的争议领域和未来的方向。

引用次数: 0

Spondylolysis and spondylolisthesis in paediatric patients: types, investigations and treatment options 脊柱裂和滑脱在儿科患者：类型，调查和治疗方案

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.006

Srood Kadir, Athanasios I Tsirikos, Jwalant Mehta, Tom PC Schlösser

Spondylolysis is a defect in the posterior vertebral arch, most commonly in L5, and spondylolisthesis is a forward slippage of a vertebra upon another, in children most commonly L5 on S1. In children, symptomatic spondylolysis generally warrants treatment by activity modifications, and treatment options such as bracing or surgical spondylolysis repair can be considered for specific cases. In progressive, low-grade spondylolisthesis that has failed to respond to conservative treatment options, spinal fusion can be performed to halt progression and correct the local deformity. High-grade spondylolisthesis requires surgical stabilization to prevent further progression of the lumbo-sacral kyphosis and progressive slip, restore global sagittal balance and prevent a decline in long-term quality of life.

脊柱滑脱是后椎弓的缺陷，最常见于L5，而脊柱滑脱是一节椎体在另一节椎体上的前滑，在儿童中最常见于L5和S1。在儿童中，症状性峡部裂通常需要通过活动调节来治疗，对于特定病例，可以考虑支具或手术峡部裂修复等治疗方案。对于进行性、低程度的椎体滑脱，保守治疗方案无效时，可以进行脊柱融合术以阻止进展并纠正局部畸形。高度椎体滑脱需要手术稳定，以防止腰骶后凸进一步恶化和进行性滑动，恢复整体矢状面平衡，防止长期生活质量下降。

引用次数: 0

How to approach and investigate a patient who presents with presumed idiopathic scoliosis 如何接近和调查推定为特发性脊柱侧凸的患者

Q4 Medicine

Orthopaedics and Trauma

Pub Date : 2025-12-01 DOI: 10.1016/j.mporth.2025.09.004

Zaki B Choudhury, Athanasios I Tsirikos

Idiopathic scoliosis is a commonly occurring condition, universal in terms of incidence across race and socio-economic backgrounds. In this review, we address technical definitions, clinical assessment and initial investigation as a prelude to management, which is discussed in a separate chapter of this issue. Generally, patients who need intervention are managed in specialist centres; it is, however, important for the general orthopaedic surgeon to recognize the condition, have an understanding of potential risks for progression and offer patients adequate advice on prognosis and treatment expectations. Knowledge of anomalies which suggest a different aetiology of scoliosis is essential for differential diagnosis and these are also covered in this review.

特发性脊柱侧凸是一种常见病，在不同种族和社会经济背景的发病率方面具有普遍性。在这篇综述中，我们将技术定义、临床评估和初步调查作为管理的前奏，这将在本期的单独章节中讨论。一般来说，需要干预的病人在专科中心得到管理；然而，对于普通骨科医生来说，重要的是要认识到这种情况，了解潜在的进展风险，并就预后和治疗预期向患者提供充分的建议。提示脊柱侧凸不同病因的异常知识对于鉴别诊断至关重要，这些也将在本综述中讨论。

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Orthopaedics and Trauma

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀