Adolescent idiopathic scoliosis (AIS) is a pathological entity of unknown etiology. The causes of osteoporosis or osteopenia in AIS remain undetermined. Whether poor bone quality is an etiologic factor remains controversial. To determine the correlation between low bone mineral status and AIS, a review of literature was performed. After a literature search from 1966 to June 2007 (using Medline, EMBASE, Cochrane DSR, ACP Journal Club, DARE, CCTR, CINAHL and hand searches of references) for studies regarding low bone mineral status and AIS, 20 studies meeting the inclusion criteria were reviewed in terms of the appropriateness of valuation technique, the validity of descriptive system, the number and type of respondents, and overall quality of the studies. Nearly all investigations demonstrated that low bone mineral density (BMD) was a generalized phenomenon and a systematic disorder in AIS. The prevalence of AIS with osteoporosis is approximately 20-38%. The follow-up studies indicated that osteopenia in patients with AIS may be a persistent phenomenon. BMD could be affected by the mechanical loading and lower bone mineral mass is always associated with lower bone strength. The spinal architecture associated with the osteopenia may aggravate the spinal deformity. However, with regard to the concave and convex femoral neck BMD values, and the correlation of BMD to scoliosis parameters, the results remain inconsistent. Bracing may not result in permanent loss of bone mineral mass. The effect of the eccentric tension-compression environments on BMD, the correlation of BMD with scoliosis parameters and the effect of bracing on BMD should be investigated further in prospective, randomized and longitudinal follow-up studies.

译文

青少年特发性脊柱侧凸 (AIS) 是病因不明的病理实体。AIS中骨质疏松症或骨量减少的原因尚未确定。骨质量差是否是病因仍存在争议。为了确定低骨矿物质状态与AIS之间的相关性,对文献进行了回顾。在1966年2007年6月 (使用Medline,EMBASE,Cochrane DSR,ACP Journal Club,DARE,CCTR,CINAHL和参考文献的手工搜索) 进行有关低骨矿物质状况和AIS的研究之后,对20项符合纳入标准的研究进行了审查。评估技术的适当性,描述系统的有效性,受访者的数量和类型以及研究的整体质量。几乎所有研究都表明,低骨矿物质密度 (BMD) 是AIS的普遍现象和系统疾病。患有骨质疏松症的AIS的患病率约为20-38%。随访研究表明,AIS患者的骨量减少可能是一种持续的现象。BMD可能会受到机械负荷的影响,而较低的骨矿物质质量始终与较低的骨强度有关。与骨质减少相关的脊柱结构可能会加剧脊柱畸形。但是,关于凹凸股骨颈BMD值以及BMD与脊柱侧弯参数的相关性,结果仍然不一致。支撑可能不会导致骨矿物质质量的永久性损失。在前瞻性,随机和纵向随访研究中,应进一步研究偏心拉伸压缩环境对BMD的影响,BMD与脊柱侧弯参数的相关性以及支撑对BMD的影响。

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