青少年特发性脊柱侧凸术后远端叠加现象研究进展

Research progress in distal adding- on phenomenon after surgical correction of adolescent idiopathic scoliosis

摘要:

青少年特发性脊柱侧凸 （adolescent idiopathic scoliosis, AIS） 是最常见的脊柱侧凸畸形。远端叠加 （distal addingon）现象是 AIS 患者后路选择性胸弯融合术后常见的并发症。远端叠加现象可影响患者生活质量。既往文献报道的主要危险因素有下固定椎的选择、生长潜能、胸弯和腰弯相关因素、L₄椎体倾斜方向、肩平衡、冠状面平衡等。但目前关于远端叠加现象发生发展的危险因素尚存在争议。本文对远端叠加现象的定义、流行病学、危险因素及防治进行综述，以期进一步认识此并发症。

Abstract:

Adolescent idiopathic scoliosis (AIS) is the most common scoliosis deformity, while distal adding-on is a common complica- tion after selective posterior thoracic fusion in AIS patients. The distal adding-on phenomenon may impact the quality of life of patients, with the main risk factors reported in the previous literature of the selection of lowest instrumented vertebra, growth potential, factors related to thoracic curvature and lumbar curvature, L₄ vertebral tilt direction, shoulder balance, coronal balance, etc. However, there is still controversy about the risk factors of distal adding-on phenomenon. This article reviews the definition, epidemiology, risk factors and prevention of distal adding-on phenomenon in order to further understand this complication.