Scoliosis - a stable spinal deformity characterized by its lateral curvature relative to the plane of the spinal column.
Sometimes in severe cases scoliosis accompanied by another kyphosis and lordosis (deflection forward and backward).
The progression of scoliosis leads to resistant strains rest of the skeleton of the chest, pelvis and extremities, leading to serious disturbances in the body.
Causes
The disease mostly occurs in the period of intensive growth of the skeleton, but in most cases is unknown reasons.
Also, scoliosis may have a traumatic nature inherent (due to violations of embryogenesis), formed in a result of metabolic disorders and problems with connective tissue, be a consequence of limb growth disorders and their different lengths.
Girls suffer up to seven times more likely than boys.
Scoliosis is more common in periods of 4 to 6 years old and at the age of 10 to 14 years. During these periods, the progression is more likely.
types of scoliosis
At present, there are many classifications of scoliosis, each of which allows for a leading sign. distinguished:
- Structural scoliosis - a curvature of the vertebrae with their lateral twisting,
- nonstructural scoliosis - curvature of the spine without his other changes.
Due to the occurrence can be identified:
- osanochny scoliosis, occurs because of problems with posture, disappears on lying down and bending forward.
- reflex scoliosis - occurs when the forced poses for back pain.
- compensatory scoliosis - develops due to the different length legs.
- hysterical scoliosis - emerges as a psychogenic trauma.
The shape of the stands:
- c-shaped scoliosis with a curvature,
- s-shaped scoliosis with two opposite bends,
- z-shaped scoliosis with three lateral bends.
Localization scoliosis can be a cervical-thoracic, breast, thoracic, lumbar, lumbar or lumbosacral.
Downstream it may be stable and progressive.
Symptoms of scoliosis in stages
In the early stages of scoliosis can be identified only by an experienced orthopedic surgeon, on the basis of certain information received from parents. It is important for early diagnosis of the disease and distinguish it from the banal posture disorders occurring at school age and measurable more accessible and easy correction.
- First of all, you need to note the presence of asymmetry of shoulders, one shoulder when the child is visually superior to the other.
- It is also important to identify violations of the distance between the arms and waist from different sides, asymmetric arrangement of blades, with heaving blade angle on the concave side of the spine.
- Curvature begins to reveal when bending forward of the body, the spine looks decidedly uneven, the spinous processes of the vertebrae deviate from the vertical center line.
In orthopedics today used clinical classification Chekalin, compiled on the basis of clinical and X-ray data, it reflects the severity of the existing scoliosis, and helps in the selection of tactics treatment.
4 severity scoliosis:
1 degree
The deviation of the spine from the longitudinal axis at an angle of 10 °.
At the same time a deviation is shown lowered head and hunched back, waist asymmetry while varying levels of standing shoulder girdle.
On the X-ray of the spine is no twisting of the vertebrae, or there is only a tendency towards them.
2 degree
The formation of the angle of curvature in the range of 11 to 25 ° to the spine axis. The angle of curvature is not changed, and does not disappear when the change in body position, either horizontally as vertically.
Wing pelvis-side curvature falls down around the waist asymmetrical triangles, the contours of the neck and shoulder girdle visually different from one another. In the area of the thoracic spine from curving appears peculiar protrusion in the lumbar region - compensatory muscle roller.
The X-ray clearly noticeable torsional deformation of the vertebrae.
3 degree of curvature
It reveals clearly pronounced signs of 2 degrees of scoliosis, wherein the curvature angle of from 26 to 50 °.
There bulging front rib arcs formed rib hump, weakened muscles in the abdomen, sink fins are formed muscle seam (contracture). On the X-ray clearly expressed twisting vertebrae.
4 degree
Has a curvature of greater than 50 °, sharp disabling deformation and twisting of the vertebrae, rib hump, significant deformation on either side of the curvature.
Diagnostics
The basis of the diagnosis - an orthopedic examination in the supine position and standing, sitting, to identify violations of posture and scoliosis. Next, you need:
- Inspection shoulder girdle, the waist, pelvis, shoulder blades,
- measurement of the length of the legs and arms,
- determination of the mobility of the joints, spine,
- examination of the chest and abdomen, the definition of muscle tone, visible defects and skeletal deformities.
Diagnostic Base - spine radiography in the supine position (with moderate elongation) and standing in direct and lateral projections. Control radiographs carried out twice a year. When existing scoliosis and when deciding on the treatment carried out by X-ray special stowage - techniques Nash, Raymond.
The growth period is conducted dimensional ultrasonic or contact sensor, light-optical profile measurement back skoliometriyu Bunnelya. In some cases, it helps to magnetic resonance imaging.
scoliosis treatment
Treatment of holds an orthopedic or vertebrologist. Allocate conservative and surgical treatment.
Conservative therapy helps with non-progressive and non-severe lesions, as it is used in the pre- and postoperative period. This includes special exercises and techniques of physiotherapy, wearing a medical corset. If you violate the leg length - special insoles or shoes.
Gym and wearing corsets are used several times a day, wear a corset with the growing spine.
- Effective in the treatment of scoliosis swimming lessons.
In the complex treatment it is also recommended to visit a massage. Recently, widespread manipulation. However, the attitude of official medicine to her ambiguous.
Application of conservative therapy is only shown in stage 1-2 scoliosis and growing spine under strict medical supervision.
A necessary condition - no screw vertebrae bend.
The angle of more than 45 ° requires surgical correction due to the formation of resistant strains of the chest, pelvis and extremities. The procedure of operation is selected individually, based on age and related disorders of the spine.
The essence of the operation - the special metal structures for straightening and fixation of the spine angle. In this case, a curved spine becomes immobilized. special grafts and touch pads, plates, hooks and pins are also used.
The prognosis for treatment
Scoliosis, particularly progressive has a poor prognosis and forms handicapped with serious limitation of ability to work.
When scoliosis small degrees contraindicated certain activities require lifelong monitoring and constant treatment, rehabilitation.
When scoliosis is contraindicated all sports that load the spine (wrestling, weightlifting).
