退变性脊柱侧凸课件

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1、DegenerativeScoliosisWangXuepengM.D.HangzhouFirstPeople'sHospitalEpidemiologycanbedifferentiatedintotwomajorgroups,i.e.,primarydegenerativescoliosisordenovoscoliosisandsecondarydegenerationofadultidiopathicscoliosistheprevalenceofscoliosisinpatientsoldert

2、han50yearsisabout6%,theaverageageofthoseseekingmedicalcareisinthesixties.thereisapotentialforcurveprogressionwithanaverageof3.3°oneyearPathogenesistheasymmetricdegenerationofthediscandthefacetjointleadstoanasymmetricloadingofthespinalsegmentandconsequentl

3、yanasymmetricdeformity,i.e.,scoliosisorkyphosistheformationofosteophytesatthefacetjoint(spondylarthritis)andatthevertebralendplates(spondylosis)contributestotheincreasingnarrowingofthespinalcanaltogetherwiththehypertrophyandcalcificationoftheligamentumfla

4、vumandjointcapsules,creatingcentralandrecessalspinalstenosisClassificationtheclassificationofLenke'smaybeabletocovertheadultidiopathicscoliosisgroupwithsecondarydegenerationbutisnotnecessarilyadequatefortheprimarydegenerativescoliosistypeClassificationSch

5、wabdistinguishedthreegroupsbasedonmeasurementsoftheendplateobliquityofL3inthefrontalplane,andofthelumbarlordosismeasuredbetweentheL1andS1superiorendplatesinthesagittalplaneClassificationCardinalSymptomsBackPainisthemostfrequentclinicalproblemofadultscolio

6、sispatientsoftencomplainofaxialbackpainduetosegmentalinstabilityatthesiteofthecurvecanbelocalizedeitherattheapexorinitsconcavityunbalanced,overloadedandstressedparavertebralbackmusclesmaybecomeverysoreandinreturnwillnotcontributetobalance,consequentlybeco

7、mingpartofaviciouscircleSpinalClaudicationisthesecondmostimportantsymptomofadultdegenerativescoliosisandmayexpressitselfas:radicularclaudicationcentralclaudicationtherootsarecompressednotnecessarilyontheconcavesideduetoanarrowforamen,butoftenontheconvexsi

8、deNeurologicalCompromiseneurologicaldeficitsoccurlateisthethirdmostimportantclinicalpresentationandmayincludeindividualroots,severalrootsorthewholecaudaequinawithapparentbladderandrectalsphincterproblemsIncreasingDe