摘要
退行性脊柱侧凸(degenerative scoliosis,DS)是一种常见于成人的脊柱畸形,椎旁肌退变在疾病发生与进展中扮演关键角色。在研究方法上,已形成包含影像学、电生理学及组织学评估等多模态综合体系。DS患者椎旁肌的病理特征表现为形态学(肌肉萎缩、脂肪浸润、左右不对称)与生物力学特性(收缩异常、平衡失调)的改变,且与冠状面参数(Cobb角)和矢状面参数[骨盆入射角与腰椎前凸角差值(PI-LL)、矢状面垂直轴(SVA)、骨盆倾斜角(PT)]有显著相关性。临床治疗策略包括保守与手术治疗,保守治疗强调康复训练、个体化原则及预后评估,手术治疗注重方式选择、近端交界失败预防。本综述为DS的防治提供了新的理论依据与实践方向,对深入理解疾病机制及优化临床决策具有重要价值。
Degenerative scoliosis(DS)is a common spinal deformity in adults,paravertebral muscle degeneration plays a key role in the occurrence and progression of the disease.In terms of research methods.a multimodal comprehensive system including imaging,electrophysiological and histological evaluation has been formed.The pathological features of paravertebral muscles in DS patients are characterized by changes in morphology(muscle atrophy,fat infiltration,left-right asymmetry)and biomechanical properties(abnormal contraction,imbalance),and are significantly correlated with coronal parameters(Cobb angle)and sagittal parameters[pelvic incidence-lumbar lordosis(PI-LL),sagittal vertical axis(SVA),pelvic tilt(PT)].Clinical treatment strategies include conservative and surgical treatment.Conservative treatment emphasizes rehabilitation training individualized principles and prognosis evaluation.Surgical treatment focuses on mode selection and prevention of proximal junction failure.This review provides a new theoretical basis and practical direction for the prevention and treatment of DS,which is of great value for in-depth understanding of the disease mechanism and optimizing clinical decision-making.
作者
张铭哲
王建龙
陈伟南
李远栋
张君涛
ZHANG Mingzhe;WANG Jianlong;CHEN Weinan;LI Yuandong;ZHANG Juntao(Rehabilitation Center,the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;不详)
出处
《中国医学创新》
2025年第32期177-182,共6页
Medical Innovation of China
基金
天津市科技计划项目(22KPHDRC00010)。
关键词
退行性脊柱侧凸
椎旁肌退变
评估方法
病理特征
治疗策略
Degenerative scoliosis
Paravertebral muscle degeneration
Evaluation method
Pathological characteristics
Treatment strategy
