Идиопатический сколиоз: общая характеристика и анализ этиологических теорий (обзор литературы)

Идиопатический сколиоз – тяжелая патология опорно-двигательного аппарата, поражающая детей и подростков во всем мире. Заболевание встречается примерно у 0,2-0,6% от общего населения и составляет самую большую подгруппу искривлений позвоночника у человека (70-90% случаев всех известных сколиозов). При идиопатическом сколиозе формируется трехмерная деформация позвоночного столба, приводящая к образованию реберного горба, искривлению ребер и грудной клетки, асимметрии таза и нарушению развития внутренних органов. Главной особенностью заболевания является спонтанное развитие деформации во время роста ребенка и тенденция к прогрессированию. Сколиоз – не только ортопедическое заболевание, но и значительная косметическая, а, следовательно, психологическая и социальная проблема. Стандарт лечения сколиотической болезни длительное время остается неизменным: наблюдение, корсетолечение и хирургическая коррекция. Прогноз развития патологии варьирует в зависимости от степени деформации. Корсетотерапия, госпитализация, хирургическое вмешательство и лечение хронических болей в спине оказывают негативное влияние на психоэмоциональное состояние детей и подростков. Несмотря на значительные успехи в способах диагностики деформации, совершенствовании методов оперативного лечения и в изучении патогенеза, этиологический фактор патологии до сих пор остается неизвестным. Поиск причин развития идиопатического сколиоза охватывает практически все аспекты его возможного происхождения: генетический, экологический, гормональный, метаболический, биохимический, неврологический и другие. В последние десятилетия были сформулированы соответствующие теории развития сколиоза, но ни одна из теорий не раскрывает сущности патологического процесса и не имеет четкого обоснования. Наибольшее количество сторонников имеет генетическая теория: генетические факторы играют ключевую роль в возникновении и развитии идиопатического сколиоза. Понимание факторов, лежащих в основе заболевания, позволит осуществлять профилактику, раннюю диагностику и выявление групп риска рассматриваемой категории пациентов.

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