思春期特発性側弯症の長期の自然経過：文献的レビュー
背景：思春期特発性側弯症（AIS）の自然経過は未治療でも，のちの健康障害は少ないと結論付けられているが，長期追跡調査を行ったデータは少なく，その解釈も研究者間にばらつきもある．目的：AISの長期自然経過の文献的レビューを行い骨成熟後に治療介入すべき症例を再評価し，これまでの研究の問題点を抽出すること．方法：PubMedを用いて文献検索を行い，175文献の内容を確認し最終的に34文献を採用した．結果：カーブ進行は胸椎カーブで進行しやすく，特に50～75°のCobb角で年間1°以下の進行がある．肺機能はCobb角と関連あり80°以上で日常生活の息切れ，110°以上で呼吸機能不全になりえる．腰痛はC...
Saved in:
| Published in | Journal of Spine Research Vol. 12; no. 11; pp. 1278 - 1286 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本脊椎脊髄病学会
20.11.2021
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1884-7137 2435-1563 |
| DOI | 10.34371/jspineres.2021-1102 |
Cover
| Abstract | 背景：思春期特発性側弯症（AIS）の自然経過は未治療でも，のちの健康障害は少ないと結論付けられているが，長期追跡調査を行ったデータは少なく，その解釈も研究者間にばらつきもある．目的：AISの長期自然経過の文献的レビューを行い骨成熟後に治療介入すべき症例を再評価し，これまでの研究の問題点を抽出すること．方法：PubMedを用いて文献検索を行い，175文献の内容を確認し最終的に34文献を採用した．結果：カーブ進行は胸椎カーブで進行しやすく，特に50～75°のCobb角で年間1°以下の進行がある．肺機能はCobb角と関連あり80°以上で日常生活の息切れ，110°以上で呼吸機能不全になりえる．腰痛はCobb角と関連はなく，頻度や重症度は健常群より高い傾向にあった．死亡率や精神疾患の有病率，社会的機能は健常者と比較しても劣っていなかった．過去の研究の問題点は，病因の解明がされていないこと，長期の自然経過に関するデータが少ないこと，Onsetの不確実性がある．結語：手術介入はCobb角が50度を超える胸椎カーブに考慮すべきでありそれ以外では多面的に考慮すべきである． |
|---|---|
| AbstractList | 背景：思春期特発性側弯症（AIS）の自然経過は未治療でも，のちの健康障害は少ないと結論付けられているが，長期追跡調査を行ったデータは少なく，その解釈も研究者間にばらつきもある．目的：AISの長期自然経過の文献的レビューを行い骨成熟後に治療介入すべき症例を再評価し，これまでの研究の問題点を抽出すること．方法：PubMedを用いて文献検索を行い，175文献の内容を確認し最終的に34文献を採用した．結果：カーブ進行は胸椎カーブで進行しやすく，特に50～75°のCobb角で年間1°以下の進行がある．肺機能はCobb角と関連あり80°以上で日常生活の息切れ，110°以上で呼吸機能不全になりえる．腰痛はCobb角と関連はなく，頻度や重症度は健常群より高い傾向にあった．死亡率や精神疾患の有病率，社会的機能は健常者と比較しても劣っていなかった．過去の研究の問題点は，病因の解明がされていないこと，長期の自然経過に関するデータが少ないこと，Onsetの不確実性がある．結語：手術介入はCobb角が50度を超える胸椎カーブに考慮すべきでありそれ以外では多面的に考慮すべきである． |
| Author | 上野, 純 梅原, 亮 仁木, 久照 赤澤, 努 飯沼, 雅央 石森, 光一 友近, 顕 鳥居, 良昭 吉田, 篤弘 浅野, 孝太 黒屋, 進吾 |
| Author_xml | – sequence: 1 fullname: 友近, 顕 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 赤澤, 努 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 飯沼, 雅央 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 上野, 純 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 浅野, 孝太 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 石森, 光一 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 梅原, 亮 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 仁木, 久照 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 吉田, 篤弘 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 鳥居, 良昭 organization: 聖マリアンナ医科大学整形外科学講座 – sequence: 1 fullname: 黒屋, 進吾 organization: 聖マリアンナ医科大学整形外科学講座 |
| BookMark | eNo9kMtKw0AYhQepYK19A18hdf6ZSSZZSvFecKPrYZrMaEOtJenGXUsKRSjdiLeiuCqCSN14QenbhCZ25SvYonRzzoFz-Pn5llGmdlpTCK0CLlBGOaz5Yb1SU4EKCwQTMAAwWUBZwqhpgGnRDMqCbTODA-VLKB-GPsaYECBgsSzaS5r3yc0guXtIzz_T26-k-ThuvY5HL-l1J24NJ5cf02oavjtPafs9fetOWr2fUT-56qTdYdpvx9FzHF3E0SCORitoUctqqPL_nkOHmxsHxW2jtL-1U1wvGT4lePqUiznWZVODyR2HgPRcJrXStscJc13QDuOepU3LcnXZsyTG4BBil7mizOOmQ3No9--uHzbkkRL1oHIigzMhg0bFrSoxByKACICZzsiIGZn5yD2WgfAl_QWILHtt |
| ContentType | Journal Article |
| Copyright | 2021 Journal of Spine Research編集委員会 |
| Copyright_xml | – notice: 2021 Journal of Spine Research編集委員会 |
| DOI | 10.34371/jspineres.2021-1102 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 2435-1563 |
| EndPage | 1286 |
| ExternalDocumentID | article_jspineres_12_11_12_2021_1102_article_char_ja |
| GroupedDBID | .55 ABJNI ALMA_UNASSIGNED_HOLDINGS JMI JSF JSH RJT RZJ X7M |
| ID | FETCH-LOGICAL-j3205-1c070fb5f1579921adc4afef8d724cc1f947d6f566cfbd6a0019228b7e34d7593 |
| ISSN | 1884-7137 |
| IngestDate | Wed Sep 03 06:31:05 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 11 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j3205-1c070fb5f1579921adc4afef8d724cc1f947d6f566cfbd6a0019228b7e34d7593 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jspineres/12/11/12_2021-1102/_article/-char/ja |
| PageCount | 9 |
| ParticipantIDs | jstage_primary_article_jspineres_12_11_12_2021_1102_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2021/11/20 |
| PublicationDateYYYYMMDD | 2021-11-20 |
| PublicationDate_xml | – month: 11 year: 2021 text: 2021/11/20 day: 20 |
| PublicationDecade | 2020 |
| PublicationTitle | Journal of Spine Research |
| PublicationYear | 2021 |
| Publisher | 一般社団法人 日本脊椎脊髄病学会 |
| Publisher_xml | – name: 一般社団法人 日本脊椎脊髄病学会 |
| References | 31) Bettany-Saltikov J, Weiss HR, Chockalingam N, et al: Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis. Cochrane Database Syst Rev. 2015; 4. doi: 10.1002/14651858.CD010663.pub2 33) Upasani VV, Caltoum C, Petcharaporn M, et al: Adolescent idiopathic scoliosis patients report increase pain at five years compared with two years after surgical treatment. Spine (Phila Pa 1976). 2008; 33: 1107-1112 18) Edgar MA, Mehta MH: Long-term follow-up of fused and unfused idiopathic scoliosis. J Bone Joint Surg. 1988; 70-B: 712-716 34) Weiss HR: Is there a body of evidence for the treatment of patients with adolescent idiopathic scoliosis (AIS) ? Scoliosis. 2007; 2: 19 16) Ascani E, Bartolozzi P, Logroscino CA, et al: Natural history of untreated idiopathic scoliosis after skeletal maturity. Symposium on epidemiology, natural history and non-operative treatment of idiopathic scoliosis. Spine. 1986; 11: 784-789 23) Cordover AM, Betz RR, Clements DH, et al: Natural history of adolescent thoracolumbar and lumbar idiopathic scoliosis into adulthood. J Spinal Disord. 1997; 10 (3): 193-196 28) Pehrsson K, Bake B, Larsson S, et al: Lung function in adult idiopathic scoliosis: a 20 year follow up. Thorax. 1991; 46: 474-478 32) Poitras B, Mayo NE, Goldberg MS, et al: The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part IV: Surgical correction and back pain. Spine (Phila Pa 1976). 1994; 19 (14): 1582-1588 25) Branthwaite MA: Cardiorespiratory consequences of unfused idiopathic scoliosis. Br J Dis Chest. 1986; 80 (4): 360-369 2) Ueno M, Takaso M, Nakazawa T, et al: A 5-year epidemiological study on the prevalence rate of idiopathic scoliosis in Tokyo: school screening of more than 250,000 children. J Orthop Sci. 2011; 16 (1): 1-6 1) Weinstein SL, Dolan LA, Cheng JC, et al: Adolescent idiopathic scoliosis. Lancet. 2008; 371: 1527-1537 29) Deyo RA, Mirza SK, Martin BI: Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine (Phila Pa 1976). 2006; 31: 2724-2727 3) Nachemson A: A long term follow-up study of non-treated scoliosis. Acta Orthop Scand. 1968; 39 (4): 466-476 21) Mayo NE, Goldberg MS, Poitras B, et al: The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part III: back pain. Spine (Phila Pa 1976). 1994; 19 (14): 1573-1581 20) Goldberg MS, Mayo NE, Poitras B, et al: The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part II: Perception of health, self and body image, and participation in physical activities. Spine (Phila Pa 1976). 1994; 19 (14): 1562-1572 10) Weinstein SL: The Natural History of Adolescent Idiopathic Scoliosis. J Pediatr Orthop. 2019; 39 (6, Suppl 1): S44-S46 4) Nilsonne U, Lundgren KD: Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand. 1968; 39 (4): 456-465 7) Weiss HR, Karavidas N, Moramarco M, et al: Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature. Asian Spine J. 2016; 10: 1163-1169 6) Ponseti IV, Friedman B: Prognosis in idiopathic scoliosis. J Bone Joint Surg Am. 1950; 32 (2): 381-395 9) Danielsson AJ: Natural history of adolescent idiopathic scoliosis: a tool for guidance in decision of surgery of curves above 50°. J Child Orthop. 2013; 7 (1): 37-41 26) Kafer ER: Respiratory and cardiovascular functions in scoliosis and the principles of anesthetic management. Anesthesiology. 1980; 52 (4): 339-351 5) Fowles JV, Drummond DS, L'Ecuyer S, et al: Untreated scoliosis in the adult. Clin Orthop Relat Res. 1978; 134: 212-217 13) Collis DK, Ponseti IV: Long-term follow-up of patients with idiopathic scoliosis not treated surgically. J Bone Joint Surg Am. 1969; 51: 425-445 11) Weinstein SL, Dolan LA, Spratt KF, et al: Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003; 289: 559-567 12) Pehrsson K, Larsson S, Oden A, et al: Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976). 1992; 17: 1091-1096 24) Leech JA, Ernst P, Gurr J, et al: Cardiorespiratory status in relation to mild deformity in adolescent idiopathic scoliosis. The Journal of Pediatrics. 1985; 106 (1): 143-149 17) Edgar MA: The natural history of unfused scoliosis. Orthopedics. 1987; 10 (6): 931-939 27) Bergofsky EH: Respiratory failure in disorders of the thoracic cage. Am Rev Respir. 1979; 119 (4): 643-669 30) Westrick ER, Ward WT: Adolescent idiopathic scoliosis: 5-year to 20-year evidence-based surgical results. J Pediatr Orthop. 2011; 31 (1 Suppl): S61-68 19) Goldberg MS, Mayo NE, Poitras B, et al: The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part I: Description of the study. Spine (Phila Pa 1976). 1994; 19 (14): 1551-1561 15) Weinstein SL, Ponseti IV: Curve progression in idiopathic scoliosis. J Bone Joint Surg. 1983; 65-A: 447-455 14) Weinstein SL, Zavala DC, Ponseti IV: Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg. 1981; 63-A: 702-712 8) Agabegi SS, Kazemi N, Sturm PF, et al: Natural History of Adolescent Idiopathic Scoliosis in Skeletally Mature Patients: A Critical Review. J Am Acad Orthop Surg. 2015; 12: 714-723 22) Bjerkreim I, Hassan I: Progression in untreated idiopathic scoliosis after end of growth. Acta Orthop Scand. 1982; 53 (6): 897-900 |
| References_xml | – reference: 32) Poitras B, Mayo NE, Goldberg MS, et al: The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part IV: Surgical correction and back pain. Spine (Phila Pa 1976). 1994; 19 (14): 1582-1588 – reference: 30) Westrick ER, Ward WT: Adolescent idiopathic scoliosis: 5-year to 20-year evidence-based surgical results. J Pediatr Orthop. 2011; 31 (1 Suppl): S61-68 – reference: 26) Kafer ER: Respiratory and cardiovascular functions in scoliosis and the principles of anesthetic management. Anesthesiology. 1980; 52 (4): 339-351 – reference: 2) Ueno M, Takaso M, Nakazawa T, et al: A 5-year epidemiological study on the prevalence rate of idiopathic scoliosis in Tokyo: school screening of more than 250,000 children. J Orthop Sci. 2011; 16 (1): 1-6 – reference: 5) Fowles JV, Drummond DS, L'Ecuyer S, et al: Untreated scoliosis in the adult. Clin Orthop Relat Res. 1978; 134: 212-217 – reference: 23) Cordover AM, Betz RR, Clements DH, et al: Natural history of adolescent thoracolumbar and lumbar idiopathic scoliosis into adulthood. J Spinal Disord. 1997; 10 (3): 193-196 – reference: 12) Pehrsson K, Larsson S, Oden A, et al: Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976). 1992; 17: 1091-1096 – reference: 11) Weinstein SL, Dolan LA, Spratt KF, et al: Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003; 289: 559-567 – reference: 7) Weiss HR, Karavidas N, Moramarco M, et al: Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature. Asian Spine J. 2016; 10: 1163-1169 – reference: 24) Leech JA, Ernst P, Gurr J, et al: Cardiorespiratory status in relation to mild deformity in adolescent idiopathic scoliosis. The Journal of Pediatrics. 1985; 106 (1): 143-149 – reference: 16) Ascani E, Bartolozzi P, Logroscino CA, et al: Natural history of untreated idiopathic scoliosis after skeletal maturity. Symposium on epidemiology, natural history and non-operative treatment of idiopathic scoliosis. Spine. 1986; 11: 784-789 – reference: 4) Nilsonne U, Lundgren KD: Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand. 1968; 39 (4): 456-465 – reference: 21) Mayo NE, Goldberg MS, Poitras B, et al: The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part III: back pain. Spine (Phila Pa 1976). 1994; 19 (14): 1573-1581 – reference: 34) Weiss HR: Is there a body of evidence for the treatment of patients with adolescent idiopathic scoliosis (AIS) ? Scoliosis. 2007; 2: 19 – reference: 10) Weinstein SL: The Natural History of Adolescent Idiopathic Scoliosis. J Pediatr Orthop. 2019; 39 (6, Suppl 1): S44-S46 – reference: 1) Weinstein SL, Dolan LA, Cheng JC, et al: Adolescent idiopathic scoliosis. Lancet. 2008; 371: 1527-1537 – reference: 19) Goldberg MS, Mayo NE, Poitras B, et al: The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part I: Description of the study. Spine (Phila Pa 1976). 1994; 19 (14): 1551-1561 – reference: 31) Bettany-Saltikov J, Weiss HR, Chockalingam N, et al: Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis. Cochrane Database Syst Rev. 2015; 4. doi: 10.1002/14651858.CD010663.pub2 – reference: 28) Pehrsson K, Bake B, Larsson S, et al: Lung function in adult idiopathic scoliosis: a 20 year follow up. Thorax. 1991; 46: 474-478 – reference: 6) Ponseti IV, Friedman B: Prognosis in idiopathic scoliosis. J Bone Joint Surg Am. 1950; 32 (2): 381-395 – reference: 20) Goldberg MS, Mayo NE, Poitras B, et al: The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study. Part II: Perception of health, self and body image, and participation in physical activities. Spine (Phila Pa 1976). 1994; 19 (14): 1562-1572 – reference: 13) Collis DK, Ponseti IV: Long-term follow-up of patients with idiopathic scoliosis not treated surgically. J Bone Joint Surg Am. 1969; 51: 425-445 – reference: 25) Branthwaite MA: Cardiorespiratory consequences of unfused idiopathic scoliosis. Br J Dis Chest. 1986; 80 (4): 360-369 – reference: 27) Bergofsky EH: Respiratory failure in disorders of the thoracic cage. Am Rev Respir. 1979; 119 (4): 643-669 – reference: 8) Agabegi SS, Kazemi N, Sturm PF, et al: Natural History of Adolescent Idiopathic Scoliosis in Skeletally Mature Patients: A Critical Review. J Am Acad Orthop Surg. 2015; 12: 714-723 – reference: 29) Deyo RA, Mirza SK, Martin BI: Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine (Phila Pa 1976). 2006; 31: 2724-2727 – reference: 3) Nachemson A: A long term follow-up study of non-treated scoliosis. Acta Orthop Scand. 1968; 39 (4): 466-476 – reference: 9) Danielsson AJ: Natural history of adolescent idiopathic scoliosis: a tool for guidance in decision of surgery of curves above 50°. J Child Orthop. 2013; 7 (1): 37-41 – reference: 33) Upasani VV, Caltoum C, Petcharaporn M, et al: Adolescent idiopathic scoliosis patients report increase pain at five years compared with two years after surgical treatment. Spine (Phila Pa 1976). 2008; 33: 1107-1112 – reference: 15) Weinstein SL, Ponseti IV: Curve progression in idiopathic scoliosis. J Bone Joint Surg. 1983; 65-A: 447-455 – reference: 22) Bjerkreim I, Hassan I: Progression in untreated idiopathic scoliosis after end of growth. Acta Orthop Scand. 1982; 53 (6): 897-900 – reference: 14) Weinstein SL, Zavala DC, Ponseti IV: Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg. 1981; 63-A: 702-712 – reference: 18) Edgar MA, Mehta MH: Long-term follow-up of fused and unfused idiopathic scoliosis. J Bone Joint Surg. 1988; 70-B: 712-716 – reference: 17) Edgar MA: The natural history of unfused scoliosis. Orthopedics. 1987; 10 (6): 931-939 |
| SSID | ssj0002212164 ssib058493330 ssib043658114 ssib044745754 |
| Score | 2.2891726 |
| Snippet | 背景：思春期特発性側弯症（AIS）の自然経過は未治療でも，のちの健康障害は少ないと結論付けられているが，長期追跡調査を行ったデータは少なく，その解釈も研究者... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 1278 |
| SubjectTerms | 思春期特発性側弯症 自然経過 |
| Title | 思春期特発性側弯症の長期の自然経過：文献的レビュー |
| URI | https://www.jstage.jst.go.jp/article/jspineres/12/11/12_2021-1102/_article/-char/ja |
| Volume | 12 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | Journal of Spine Research, 2021/11/20, Vol.12(11), pp.1278-1286 |
| journalDatabaseRights | – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 2435-1563 dateEnd: 99991231 omitProxy: true ssIdentifier: ssib044745754 issn: 1884-7137 databaseCode: M~E dateStart: 20200101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1LaxRBEB5ivHgRRcU3OdgnmTjT3TPdfezZzBKUeDGB3IZ5HvYQgyYXD5KwgSAEL-IrKJ6CIBIvPlDyb5bsmJMn71b1PHbFHDQIw1Db_VVNddX0dtVuPyzrmkyYl8JluzwVNpeZY8eJl9lZwYSM41QohQuF5277swv85qK3OHHs59ispdWVZDp9cOi6kqN4FcrAr7hK9h882wqFAqDBv3AHD8P9r3xMQt_MVJhBQkmiPUN0iOqSUBCpSKCQUEDoGqwFCT2IH0nAkQg6RBuwAjxUMazSIQkVUVArxgS2VRKRWptHcBL4SAQgs4NcgJGA6aJkZR6qfCNZIADZBZYDIwpkRHdqQrGmxKuJ-tTtP0PnO8sYGzeTBpt3xrSrS2SAGgZdolx8f1An7ZLqjM0KJlFbzVG3IETCwIBZQ6tGMOBjxjgAo9icWpoKiPQQD5w6HOHBFBJloBEEGsHgBRq6OmG5-XWFurjMkDptf2h4HWNbaWwiUDyoB8-BB4ImqAZDpyBYw3XdGFeMvI5sEi0rjd2BX4ZjJdCewNi9cnbVhBmifSMRvTU2QkmJE2irnXKmc1NGIea1IRFnvw1rdLz7umODlEurU5PqgAciFP-wwZRxJsxoeh-dei_Hze2NgRw6Ch7aKZ11J4hadORSSC_xjmwRskUNCFcURj1Ia45T4ft48Mjcw7AZBjiDqNgd_bnPueCQVLSfIWRWjNVZb8_s4OTSaqO41jjVIlnTghuH6A_hZg-Sr2bipokl509ZJ-s3eUpXep62JnrxGevWcO318MXO8NWb8tHX8uW34drb_fWP-3sfyuebg_Xdg6dfoAqI75vvyo3P5aetg_XHP_a2h882y63dcntj0H8_6D8Z9HcG_b2z1kI3nO_M2vVRJ3aPUdwLOIWht0i8wvXg25G6cZbyuMgLmQnK09QtFBeZX0DulRZJ5scmM6MyETnjmfAUO2dNLt1dys9bUyJLnMzPUhl7Dk_jIk5iJ_dYonLIBFI3vWB1qrZHy9V-NtFRXHfxv0i5ZJ0YdbrL1uTKvdX8CgT5K8lV80r8AuDz1Xk |
| linkProvider | ISSN International Centre |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E6%80%9D%E6%98%A5%E6%9C%9F%E7%89%B9%E7%99%BA%E6%80%A7%E5%81%B4%E5%BC%AF%E7%97%87%E3%81%AE%E9%95%B7%E6%9C%9F%E3%81%AE%E8%87%AA%E7%84%B6%E7%B5%8C%E9%81%8E%EF%BC%9A%E6%96%87%E7%8C%AE%E7%9A%84%E3%83%AC%E3%83%93%E3%83%A5%E3%83%BC&rft.jtitle=Journal+of+Spine+Research&rft.au=%E5%8F%8B%E8%BF%91%2C+%E9%A1%95&rft.au=%E8%B5%A4%E6%BE%A4%2C+%E5%8A%AA&rft.au=%E9%A3%AF%E6%B2%BC%2C+%E9%9B%85%E5%A4%AE&rft.au=%E4%B8%8A%E9%87%8E%2C+%E7%B4%94&rft.date=2021-11-20&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E8%84%8A%E6%A4%8E%E8%84%8A%E9%AB%84%E7%97%85%E5%AD%A6%E4%BC%9A&rft.issn=1884-7137&rft.eissn=2435-1563&rft.volume=12&rft.issue=11&rft.spage=1278&rft.epage=1286&rft_id=info:doi/10.34371%2Fjspineres.2021-1102&rft.externalDocID=article_jspineres_12_11_12_2021_1102_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1884-7137&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1884-7137&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1884-7137&client=summon |