脊柱側弯症学校検診で発見された側弯症の自然経過

Natural History of Idiopathic Scoliosis Detected by Screening Schoolchildren

　目的：脊柱側弯症学校検診で発見された軽度特発性側弯症の自然経過を調査し，地域の整形外科クリニックで経過観察するうえで参考となる指標があるかについて検討した．

　対象と方法：過去16年間に10°以上の側弯症で観察期間が12カ月以上の237例を対象に，最終観察時Cobb角が初診時から5°以上変化したものを改善，悪化とし，5°未満の変化を不変として評価した．

　結果：結果は改善例16.5％，不変例61.6％，悪化例21.9％であった．

　まとめ：初診Cobb角15°以上でRisser sign 0，1，2のものは進行悪化する傾向が大きく，経過観察するうえで一つの指標と思われた．

　Background：We assessed the natural course of mild idiopathic scoliosis detected during screening of schoolchildren in order to to define a prognostic index for use in follow-up consultations in local orthopedic clinics.

　Methods：We reviewed 237 cases with a Cobb angle over 10 degrees that we had examined for more than a 12-month period during the past 16 years.　We checked for changes in the Cobb angle in this period and classified them into three groups：an improved group with a greater than 5-degree decrease, an exacerbated group with a greater than 5-degree increase, and a stable group with no more than a 5-degree change in Cobb angle.

　Results：The percentages of screenees in each group were：16.5% in the improved group, 61.6% in the stable group, and 21.9% in the exacerbated group.

　Conclusions：We found that screenees with a greater than 15-degree Cobb angle and a Risser sign of 0,1,and 2 tended to experience an exacerbation.　We considered these findings to serve as an important prognostic indexes.