The spine is our inner frame. It performs supporting, motor, depreciation, protective functions. Violation of these functions occurs with spinal deformities. To get them back, you need to engage in the prevention and timely treatment of curvature of the spine. Pathology is handled by an orthopedist, vertebrologist and neurologist. It all depends on the cause of the curvature and the presence of concomitant pathologies. Normally, it has several bends in each of its departments, which are located in the sagittal plane (when viewed from the side).
Physiological curves of the spinal column
- Cervical and lumbar lordosis. They are formed in the process of the physical development of the child, when his motor abilities expand (begins to hold his head and sit). Are the bulge of the spine anteriorly.
- Thoracic and sacral kyphosis are formed in utero, the baby is already born with them. Represented by a bulge at the back.
In the frontal plane, the line of the spine runs along the middle axis of the body. Active and correct retention of the body in space is posture. Deformation of the spine leads to the development of abnormal posture and vice versa.
Types of diseases
What are the types of spinal deformity? What most often worries modern man? Scoliosis develops in the frontal plane. This is a curvature of the spinal column relative to the midline to the right or left. In the sagittal plane, there is an increase in the arc of physiological curves (hyperlordosis, hyperkyphosis), disappearance or reduction of curves (flat back) and combined curvatures combining two directions (lordoscoliosis, kyphoscoliosis).
Why does the curvature occur?
The causes of spinal deformity can be congenital or acquired. Congenital etiology is associated with the pathology of the vertebrae:
- Underdevelopment of structural components.
- Additional elements.
- Fusion of neighboring vertebral bodies.
- Arc failure.
- Wedge shape.
The causes of acquired spinal deformity can be:
- Regularly bad posture.
- Rickets (calcium imbalance in the body, bones become brittle).
- Tuberculosis of the spine.
- Polio.
- Osteochondrosis and osteodystrophy.
- CP.
- Injuries, hernias and tumors of the spine.
- Pleurisy is a pathology of the respiratory system with a pronouncedpain syndrome. Usually one side on which the patient lies is affected. The load on the spinal column in the thoracic region is uneven, a curvature occurs.
- Shortening one of the lower limbs - the load is distributed unevenly.
- Missing one arm or leg, resulting in imbalance.
- Weak muscle mass, which is not able to withstand the curvature of the spine.
- Mental disorders (depression, when the shoulders and head are constantly lowered).
Curvature of the spinal column can affect any part of it.
Cervical spine deformity
- Torticollis is a pathology in which the head is tilted to one side and the neck is turned to the other.
- Kyphosis - curvature of the neck backwards. This is a rare occurrence.
- Lordosis - strengthening the physiological bend. The neck is stretched forward, the shoulders are rounded, the stoop develops.
Causes of congenital torticollis:
- incorrect intrauterine position of the fetus;
- birth trauma;
- spasm or shortening of the neck muscles;
- congenital pathology of the cervical vertebrae (Klippel-Feil disease);
- rotational subluxation of the 1st cervical vertebra.
Causes of acquired deformity of the cervical spine:
- adjusting torticollis - when a child takes the wrong position in the crib for a long time;
- compensatory - with inflammatory diseases of the ear, purulent processes in the neck(the child spares the sick side and tilts his head to the he althy side);
- fracture, dislocation or subluxation of the first cervical vertebra;
- osteomyelitis, tuberculosis, tertiary syphilis - the vertebrae are destroyed, axial deformation of the skeleton occurs.
Treatment of torticollis
Conservative methods:
- massage;
- therapeutic gymnastics;
- position treatment;
- physiotherapy;
- water procedures in the pool using a circle for newborns;
- wearing a collar that fixes the cervical spine in the correct position.
Surgical treatment is performed in the absence of the effect of conservative:
- myotomy - dissection of the neck muscle;
- plasty (muscle lengthening).
Kyphosis and lordosis are treated with conservative methods (exercise therapy, massage, drug anesthesia, muscle spasm relief).
Thoracic Disorders
Kyphosis is accompanied by deformation in the form of increased physiological bending. There is a pathological posterior bend with the formation of a round back. Acquired kyphotic deformity of the spine is more common.
Causes of thoracic kyphosis:
- Weakness of the muscular corset, which does not have time to form after the accelerated growth of the child.
- Early rickets (up to 1 year) - the thoracic and lumbar regions are affected. The deformity disappears in the supine position (non-fixed curvature). The severity of the pathological bend is aggravated when the child sits down and stands up.
- Late rickets (5-6 years) - developingfixed kyphosis and kyphoscoliosis.
- Osteochondropathy is observed at the age of 12-17 years. Boys are more often affected. In the medical world, it is called Scheuermann-Mau disease. Dystrophic changes develop in the vertebral bodies and intervertebral discs. A fixed wedge-shaped deformity of the spine is formed.
Treatment of thoracic kyphosis
Rachitic deformity is treated conservatively: swimming, vitamin therapy, exercise therapy, coniferous baths, massage, wearing a special three-point corset. The disease may disappear without a trace.
Youthful kyphosis is treated in a complex way: massage, special exercises to strengthen the muscular corset, drug improvement of the trophism of the osteoarticular system. Often it is necessary to use surgical methods of therapy: various types of instrumental fixation of the spine.
Lumbar deformity
Lordosis - curvature of the spinal column with the formation of a bulge in front. Therapy is based on the fight against the disease that caused the curvature. They use traction, special patient styling, physiotherapy, physiotherapy exercises and general strengthening massage courses.
Causes of lumbar lordosis:
- deformation to compensate for rachitic and tuberculous kyphosis;
- dislocations of the hips that occurred during childbirth;
- contractures of the hip joints.
Scoliosis
Scoliotic deformity of the spine can affect any level of the spine and affectseveral departments, causing S-shaped curvatures. Prepubertal girls are more susceptible to the disease.
- Congenital scoliosis is associated with the presence of fusion of several vertebrae, the presence of additional vertebrae, an anomaly in the structural components of the vertebra. It occurs in babies under the age of 1 year. Progresses slowly, curve lines are not pronounced.
- Dysplastic scoliosis is formed in the pathological development of the lumbosacral region. It is found at the age of 9-11 years and progresses rapidly. The line of curvature is observed in the lumbar region.
- Neurogenic scoliosis develops as a result of poliomyelitis, syringomyelia, myopathies. The mechanism of development is associated with damage to the motor roots of the spinal cord. Functional insufficiency of muscles develops. In parallel, dystrophic changes in the spine occur.
- Rachitic scoliosis. Due to a violation of calcium metabolism, the bone tissue becomes soft. Under static loads, there is an increase in physiological bends. With the wrong position of the body in space, scoliosis quickly forms.
- Idiopathic scoliosis is the most common spinal deformity. It is a multifactorial disease: a violation of the growth rate of the spine, neuromuscular insufficiency, an active period of growth in children and an increase in physiological stress on the skeleton. There is a violation of endochondral bone formation in the vertebrae, followed by the development of osteoporosis and spinal disorders.
In 1965, V. D. Chaklin radiologically identified 4 degreesspinal deformities in scoliosis:
- 1st degree - 5-10 degrees;
- 2nd degree - 11-30;
- 3rd degree - 31-60;
- 4th degree - over 61 degrees.
Clinical manifestations of scoliosis:
- At the 1st degree in the standing position, weakness of the muscular corset of the back and abdominal wall is noted, different levels of the shoulders, the angles of the shoulder blades are located at different levels, asymmetry of the triangles of the waist. In the thoracic region, a curvature is noticeable, in the lumbar region, on the opposite side, there is a muscular seal, which is also visible when the body is tilted forward. There are no signs of rotation of the vertebrae on the x-ray. The pelvis is located in a horizontal plane. In the supine position, weakness of the abdominal muscles is noted.
- At the 2nd degree, the S-shaped curvature of the spine is visually determined. There are rotations of the thoracic vertebrae, there is a deformation of the chest. The tilt test shows the protrusion of the ribs on one side or the muscles of the lower back. Progression continues as the child grows.
- At the 3rd degree, a pronounced deformation of the skeleton is determined. The costal hump and pelvic tilt are clearly visible. The line of the shoulders coincides with the line of the pelvis. The venous plexus of the spine is compressed. There may be respiratory problems.
- At the 4th degree, there is a severe degree of deformation of the entire body. Growth stops, the relationship of internal organs is disturbed. Compression of the spinal cord leads to the development of paresis. The radiograph showswedge-shaped vertebrae.
Scoliosis is a serious disease that can lead to permanent disability (disability).
Scoliosis treatment
Spinal deformities in children should be detected in the initial stages. In such cases, all you need is posture correction, physical exercises, swimming, organizing the right workspace, maintaining an adequate work and rest regime, and proper nutrition.
Non-surgical treatment is aimed at fixing the spine in the correct position by wearing corrective corsets, training the muscles of the back and abdominals. The child's room should have a special bed with a hard mattress and an orthopedic pillow.
The second degree is treated conservatively, with the progression of the process, children are sent to specialized sanatoriums. A planned course of non-surgical treatment is being carried out in the departments of orthopedics. Use the traction method using lateral traction. This treatment lasts 2-4 months. Traction is often a preoperative preparation for the 3rd and 4th stages. The achieved level of correction is fixed promptly using special tools.
Indications for surgical treatment
- Aesthetic defect that worries an adult or parents of a small patient.
- The angle of curvature is more than 40 degrees, but with incomplete growth.
- Any warp greater than 50 degrees.
- Persistent neurological complications and pain syndrome.
- Deformations,accompanied by a violation of the cardiovascular and respiratory systems.
Types of surgical treatment
There are 3 ways: operations with front access, with back and combined. The essence of operations is the introduction of metal structures into the spine, which can be static and mobile. The advantages of a dynamic implant: it can be adjusted to ensure the correct growth of the child, and allows you to play sports. The design is not externally visible and can be used in the treatment of severe spinal deformities in adults. It allows you to fix the curvature and stop its progress.
Prevention of curvature of the spine
- Early detection of congenital curvature of the spinal column (examination by an orthopedist in the maternity hospital is carried out at 1, 3, 6 months and a year) and their correction.
- Identification of acquired deformities in preschool and school age at medical examinations and the application of appropriate measures to correct them.
- Control your posture. Children should be taught from childhood to keep their back straight. Schools should have desks with adjustable table and chair heights. During work, it is necessary to take small breaks from walking to avoid static load on the spine.
- Timely detection and treatment of rickets, polio, tuberculosis.
- Preventive courses of general massage for passive strengthening of the muscular corset.
- Sports to strengthen back muscles and abs.
- Swimming.
- In the absence of limbs, it is necessarysolve the issue of prosthetics.
- Wearing orthopedic shoes for different leg lengths.
- When lifting weights, you need to evenly distribute the load on both halves of the body.
- Eat right, food should be balanced in terms of proteins, fats and carbohydrates, vitamins and trace elements. Avoid overeating and gaining excess weight, which serves as an additional factor in the development of spinal deformities.
- Avoid a long position in one position, arrange physical education.
- Organize the correct sleep pattern. The bed should be hard, and it is better to buy an orthopedic pillow in a special salon.
- In case of visual impairment, it is necessary to contact an ophthalmologist (with reduced vision, a person can take a forced position, stretch his neck and aggravate cervical lordosis).
- Fight depression and apathy.
- Take precautions to prevent injury.
- Timely treat hernias, osteochondrosis, tumors of the spine.
Timely treatment can completely eliminate spinal deformity.
