Scoliosis of the spine is a persistent curvature, which can lead to a deterioration in the appearance of a person and disruption of the functioning of internal organs. Most often, the pathology develops in childhood or adolescence. As the disease progresses, there is a risk of damage to the internal organs. Therefore, it is so important to start treatment in a timely manner.
The essence of pathology
Scoliosis is a stable deformation of the spinal column, which is characterized by lateral curvature in a certain direction. Another feature of the disease is the twisting rotation of the spine around its own axis. This leads to a serious violation of the functions of various organs.
In addition, scoliosis can cause the formation of osteochondrosis, radiculitis, hernias and other diseases of the back.
The causes of scoliosis are diverse. The nature of the disease is congenital or acquired. The first form is the result of abnormal formation of the spine. Such scoliosis accounts for about 25% of all cases of the disease.
The acquired form of the disease usually occurs in 5-16 years. This age accounts for the period of development and complete formation of the spinal column.
By the nature of the anatomical changes, pathology is structural and non-structural. In the second case, the spinal column is bent without anatomical defects in the vertebrae. Such pathologies are secondary in nature and are acquired throughout life. In this case, the causes of scoliosis include:
- Permanent violation of posture in schoolchildren;
- Traumatic lesions of the legs and pelvis;
- Sciatica and hernia as a result of osteochondrosis;
- Limb shortening;
- Inflammation of the muscle tissue – myositis;
- Diseases of the digestive organs and kidneys.
Typically, such pathologies can be easily corrected. To do this, you need to cope with the main pathology that caused the ailment.
The structural form of scoliosis is associated with a violation of the structure of muscle, nerves, vertebrae, ligaments. In this situation, the curvature is combined with anomalies of other structures of the musculoskeletal system and organs. Individual patients even begin to lag behind in mental development.
Such forms of the disease can be congenital or acquired. The key causes of scoliosis in this case include:
- Hereditary connective tissue diseases – this category includes Marfan syndrome, neurofibromatosis, etc .;
- Organic pathologies of the spinal cord – they can occur with syringomyelia, poliomyelitis;
- Congenital malformations in the chest area;
- Rickets, pathologies of the parathyro >
As already mentioned, scoliosis is structural and non-structural. In the second case, lateral curvature of the spine usually occurs, which is not accompanied by stable rotation. Depending on the provoking factor, non-structural scoliosis can have the following varieties:
- Posture – is a consequence of a violation of posture, disappears when leaning forward and performing radiography in a horizontal position;
- Reflex – associated with the forced position of the body that a person takes in connection with pain;
- Compensatory – is the result of shortening the legs;
- Hysterical – has a psychogenic origin and is observed very rarely.
Structural scoliosis also has several forms, depending on the etiology:
- Traumatic – associated with damage to the musculoskeletal system.
- Cicatricial – develops as a result of serious cicatricial lesions of soft tissues.
- Myopathic – due to muscle damage. These include progressive dystrophy of muscle tissue and myopathy.
- Neurogenic – is a consequence of syringomyelia, neurofibromatosis, poliomyelitis and other abnormalities.
- Metabolic – associated with metabolic disorders and a deficiency of certain elements in the body. This disease can be a consequence of rickets.
- Osteopathic – occurs as a result of a congenital pathology of the spine.
Depending on the time of occurrence, idiopathic scoliosis can take the following forms:
- Infantile – develops in 1-2 years;
- Juvenile – occurs in 4-6 years;
- Teenage – appears at 10-14 years old.
The following types of scoliosis are distinguished by the shape of the curvature:
- C-shaped – 1 lateral bend is observed;
- S-shaped – there are 2 bends;
- Z-shaped – there are 3 lateral bends.
Depending on the area of localization of the curvature, the following types of scoliosis are distinguished:
- Cervicothoracic – the upper part of the curvature is located in the region of III-IV thoracic vertebrae;
- Thoracic – the peak of curvature is located in the region of VIII-IX thoracic vertebrae;
- Thoraco-lumbar – the apex of curvature is localized in the region of the XI-XII thoracic vertebrae;
- Lumbar – localized in the I-II region of the lumbar vertebrae;
- Lumbosacral – located in the I-II sacral and V lumbar vertebrae.
Depending on the characteristics of the course of the disease, scoliosis is progressive or non-progressive.
In order for the treatment of scoliosis to be as effective as possible, it is very important to make the correct diagnosis. In the initial stages, the disease has an asymptomatic course. Therefore, it is worth considering such manifestations:
- In an upright position with hands pressed to the sides, the distance between the waist and upper arm on each side is different;
- One shoulder is located above the second;
- The blades have an asymmetric arrangement;
- When tilted, you can see the curvature.
It is worth considering that the symptoms of spinal scoliosis differ depending on the degree of the disease:
- The first degree – the angle of curvature is less than 10 degrees. This form of the disease is characterized by drooping of the head, stoop, asymmetry in the waist area, different height of the shoulders. In the pictures you can see a slight tendency to torsion of the vertebrae.
- The second degree – at this stage, the angle of curvature is 11-25 degrees. For this form of the disease, the curvature of the spine is characteristic, which does not disappear with a change in the position of the trunk. On the curved s >
First of all, a visual inspection is carried out. Also, the doctor must perform a special test in an incline. The asymmetry of the shoulder girdle, the curvature of the spinal column, the secondary curvature of the pelvis and shortening of the legs are diagnosed with scoliosis.
To determine the degree of violation, the location and features of the curvature, as well as assess the condition of internal organs, the diagnosis of scoliosis involves such studies:
- Magnetic resonance imaging;
- Ultrasound procedure;
Methods of therapy
The treatment of scoliosis in adults should be selected by a vertebrologist or orthopedist. The disease can develop quite quickly and provoke damage to internal organs. Therefore, it is so important to choose adequate therapy in a timely manner. If necessary, the patient is referred to other doctors – a pulmonologist, cardiologist, etc.
Scoliosis can be treated with conservative or surgical methods. A specific method is selected depending on the cause and severity of the pathology. However, it is very important that the treatment be comprehensive.
If the development of the disease is associated with traumatic injuries, shortening of the limbs or other similar factors, first of all, they eliminate the cause of the disease. For this purpose, special insoles or special orthopedic shoes can be used. Thanks to these devices, it is possible to compensate for differences in the length of the limbs.
If scoliosis is myopathic or neurogenic in nature, conservative treatment will not give the desired results. In such a situation, surgery is required.
Conservative treatment of idiopathic scoliosis consists in therapeutic exercises and the use of corsets. If the angle of curvature is less than 15 degrees and there is no rotation, it is enough to perform special therapeutic exercises.
If the angle of deformation is 15-20 degrees and rotation is observed in people with incomplete growth, in addition to gymnastics, you need to use a special corset. Such devices can be used exclusively at night or continuously. In this case, it is worth focusing on the doctor’s recommendations. If the growth process is completed, the corset is not used.
If progressive scoliosis is observed, which is accompanied by a curvature angle of more than 20-40 degrees, in-patient therapy is performed. It is performed in a vertebrological institution.
If the growth is not completed, continuous use of a derotting corset is indicated. It should be worn at least 16 hours a day. However, it is better to use the device 23 hours a day and combine it with intensive physical therapy exercises. After the end of growth processes, the corset is not used.
If the angle is more than 40-45 degrees, it is not possible to do without surgical intervention. Indications for the operation are determined individually. They depend on the cause of the disease, the age category of the patient, physical and mental characteristics. Also of great importance is the shape and location of the curvature, as well as the effectiveness of conservative therapy.
Surgical intervention for this disease is to straighten the spine. It is carried out to a certain angle and involves the use of special metal devices.
The part of the spine that underwent surgery is subject to immobilization. To fix the spine, special devices can be used – screws, rods. Hooks or plates are also used.
To expand the vertebrae and give the spinal column a more regular shape, the use of bone grafts is shown, which is the appearance of the inserts. Surgery for this pathology can be carried out in a dorsal or transthoracic manner.
With scoliosis, which is accompanied by a curvature angle of more than 10 degrees, certain restrictions on physical activity are required.
Key contraindications for scoliosis include:
- Body rotation. Under the ban are complex body turns along the axis of the spine.
- Acrobatics, gymnastics and other training to develop flexibility of the spine. Many movements are asymmetric in nature, and therefore they are strictly prohibited in the presence of such a diagnosis.
- Power training. Any movements using a barbell or dumbbell significantly increase the load on the spine.
- Jumping Such exercises have a serious effect on the vertebrae and discs, leading to an increase in stress.
- Run. This sport is not always prohibited. In the initial stages of curvature, light running with scoliosis is allowed. However, it is important to ensure that the disease does not progress.
- Flip-flops. With the development of the disease, performing this exercise significantly increases the risk of injury.
What is dangerous scoliosis of the spine? This question interests a lot of people. The main consequences of scoliosis include the following:
- Chronic back pain
- High probability of the appearance of spondylarthrosis;
- Deterioration in appearance and the associated psychological discomfort;
- Damage to internal organs – severe forms of pathology can lead to diseases of the lungs and heart;
- Potency deterioration in men;
- Weak labor in women;
- Weakening of the immune system;
- Allergic reactions;
- Circulatory disturbance in the brain.
To avoid curvature of the spine, a number of recommendations should be followed:
- Properly organize the workplace, which will ensure the preservation of the normal position of the spine;
- Every 15-25 minutes to change the position of the body in case of sedentary work;
- Every hour interrupt sedentary work by walking around the office;
- Daily exercise, including tilting and turning the back;
- Choose a mattress of moderate stiffness;
- Time to treat back diseases;
- Avoid excess weight.
That is why the treatment and prevention of scoliosis should be carried out by a qualified doctor. At the very first symptoms of the anomaly, you should contact an orthopedist or vertebrologist and clearly follow all the recommendations of a specialist.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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