Scoliosis is a deformity of the spine, which develops its lateral curvature and simultaneous rotation of the vertebral bodies. As a rule, this disease is diagnosed in childhood. As the child grows, scoliosis can progress. Pathological changes become more pronounced.
Quite often this disease is confused with a violation of posture, when there is a curvature of the spine, but the vertebral bodies do not change their position. To make this diagnosis, such violations are mandatory.
It should be noted that scoliosis of the cervicothoracic spine, as well as curvature in the chest, lower back and sacrum can develop.
Etiology
In 80% of cases, the causes of the disease remain unknown, so they talk about idiopathic scoliosis. If you specify the etiological factors that lead to congenital curvature, you should name the following:
• fusion of the vertebrae;
• fusion of the ribs (in this case, scoliosis developsthoracic spine);
• the presence of underdeveloped vertebrae, improper development of their processes and arches (such pathological changes lead to the fact that the spinal column develops asymmetrically).
Causes and types of acquired scoliosis
As a result of the action of factors that affect the body from the outside, a curvature of the spine develops, which is diagnosed after birth.
The following types of congenital scoliosis can be distinguished:
1. Neurogenic - occurs with lesions of the nervous system. It develops after poliomyelitis, degenerative lesions of the spinal cord, with cerebral palsy or myopathy. These diseases cause paralysis of the motor nerves. This leads to dysfunction of the muscles that maintain the correct position of the body.
2. Rachitic - observed with a lack of vitamin D, characterized by muscle hypotension, bone deformity, osteoporosis.
3. Static - associated with the deformation of the legs, when the pelvis is placed in space incorrectly, which leads to deformations of the entire spine.
4. Idiopathic - usually diagnosed in children after 10 years of age.
Scoliosis of the thoracic spine: degrees of severity
Normally, there are physiological curves in the spine, as a result of which it resembles the letter S. With scoliosis, curvature of the spine of different sizes occurs. The greater the angle of displacement from the main axis, the more difficult this pathology is to correct.
BMost cases are diagnosed with right-sided scoliosis of the thoracic spine. Depending on the angle of curvature, the following degrees of severity are distinguished:
• light - the angle of curvature reaches no more than 10°;
• moderate severity - this indicator is 10-25°;
• heavy - curvature can reach 50°;
• very severe - characterized by deformed ribs and an angle of curvature that is more than 50°.
It should be noted that at the beginning of the disease, you can notice only one bend of the spine to the side, but later another is formed, which is localized below the first, but goes in the opposite direction. Left-sided scoliosis of the thoracic spine has no fundamental differences (the difference is only in the direction of the scoliotic curve).
Manifestations of cervicothoracic curvature of the spine
Such scoliosis is also called upper thoracic. This form of the disease is characterized by the fact that the primary curve of curvature is short and steep, and the secondary is rather flat and long.
It should be noted that such scoliosis is rare, but has a characteristic clinical picture, which is associated with the involvement of not only the cervical vertebrae, but also the bones of the facial skull in the pathological process.
On examination, the doctor may notice severe torticollis, asymmetrical placement of the eyes, or oblique localization of the nose. In addition, deformities of the upper chest and shoulder girdle are diagnosed. The patient's neck looks shortened, the edge of its trapezius muscle protrudes sharply, which is difficult to correct, especially whenlate initiation of therapy.
With a pronounced deformity of the chest and thoracic vertebrae, they speak of thoracic scoliosis. It is important to identify this pathology by the time the formation of the spine is completed (by the age of 20-21 years). Otherwise, treatment may be hopeless.
Thoracic Scoliosis Clinic
This disease can be detected by evaluating the data that is obtained when examining a patient. So, if there is scoliosis of the thoracic spine, you can visually notice the line of the spinal column bent to the side, the asymmetric placement of the shoulders, the shoulder blades raised up, and the protruding abdomen due to poor posture.
In addition to visual symptoms, thoracic scoliosis is characterized by certain complaints from the patient. As a rule, people with such a curvature of the spine note discomfort in the chest and pain in the area between the shoulder blades, which can be explained by infringement of the nerve processes. In severe cases, patients experience respiratory and cardiac disorders.
With further progression, both left-sided and right-sided scoliosis of the thoracic spine leads to anatomical disorders in the structure of not only the chest, but also the abdominal cavity, which is accompanied by pathological changes in the digestive organs.
Diagnosis
Scoliosis of the thoracic spine, the symptoms of which can be mild, requires the attention of doctors, because the treatment of such skeletal disorders ismore effective when seeking medical help early.
In the early stages of the disease, fluoroscopy in two projections allows not only to confirm the presence of scoliosis, but also to determine the most optimal methods of treatment. It should be remembered that with the curvature of the spine, concomitant serious diseases can occur. Incorrect distribution of body weight in scoliosis leads to degenerative changes in the vertebrae, dorsopathy of the spine, as well as to osteochondrosis and intervertebral hernias.
Scoliosis can be diagnosed with the naked eye. On examination, a difference in shoulder height is noticeable, as well as a crooked line of the vertebrae, which becomes even more noticeable if the patient leans forward.
If you are interested in what scoliosis of the thoracic spine looks like, a photo of this pathology is presented below.
Scoliosis treatment
The success of therapy depends on timely diagnosis. The sooner this pathology is detected, the greater the chance of obtaining positive results.
It should be noted that an individual plan of therapeutic measures is drawn up for each patient. At the same time, the stage of the disease and the features of its course are taken into account. As a rule, when scoliosis of the thoracic spine is diagnosed, treatment is carried out in three stages:
• direct effect on the sections of the spinal column in which lateral curvature was found;
• procedures to correct scoliosis;
• consolidation received after therapythe correct position of the spine.
It should be noted that the last stage is the most difficult. Patients do not pay due attention to it, so scoliosis develops again. That is why it is important to follow all the doctor's instructions, develop back muscles and correct posture. Therapy should be comprehensive and include conservative methods of treatment, and, if necessary, surgery.
Therapeutic gymnastics
One of the main conservative therapeutic methods is exercise therapy. Especially effective is a specially designed set of exercises, which in childhood has not only a rehabilitation, but also a therapeutic effect. Its main goal is to reduce the load on the spine, eliminate muscle imbalance, strengthen the ligamentous apparatus and form the correct posture.
As a rule, it is recommended to perform exercises that strengthen the muscle group that supports the spinal column, and also have a corrective effect on its curvature, improve the function of external respiration and have a general strengthening effect on the body.
The following types of exercises are most often recommended:
• lie on your back, bending your knees, lift your pelvis, bending in the thoracic region;
• Hanging on the bar gives a positive effect, in which you should slowly turn your torso to the sides;
• lie on your stomach and lift your torso so that the thoracic spine sags;
• tothe curvature has not progressed, you need to put a stick at shoulder level, wrap your arms around it and walk with it like this every day for 2 hours;
• The bicycle exercise also has a positive effect on curvature of the spine.
When there is scoliosis of the thoracic spine, the exercises should be performed at a slow pace. After class, it is good to rest for 20 minutes, lying on your side.
Patients, in addition to exercise therapy, are also recommended to wear special corsets and go swimming.
Massage
It must be said right away that in cases where the patient has been suffering from scoliosis for quite a long time, and there are pronounced pathological changes in the spine, massage will not give a positive result.
As a rule, it is prescribed for 1 or 2 degrees of curvature. Massage is carried out in a clinic or hospital. A set of exercises is selected individually depending on the form and severity of the disease, appointing it every 6 months.
When scoliosis of the thoracic spine is detected, massage is carried out with the obligatory consideration of the direction of deformation. Since the muscles on one side of the scoliotic curve are in constant tone, the massage therapist uses techniques that promote relaxation. On the other side, the muscle fibers are stretched and weakened, so a massage technique is needed that would tone and strengthen them.
It should be noted that self-massage for scoliosis is contraindicated, since the wrong tactics of its implementation can provokeincrease in deformity and worsen the patient's condition.
Surgical treatment of scoliosis
Despite the high level of modern medicine, severe forms of scoliosis are difficult to correct. The most effective treatment is the use of metal implants.
Surgical intervention is carried out by two methods:
1. Anterior mobilization of the spine (or multilevel discectomy with simultaneous deformity correction). This surgery is performed under general anesthesia. The most optimal results after the operation are a decrease in the angle of the scoliotic curve from 30 to 54°.
2. Halpelvictraction combined with deformity correction. This surgical intervention is even more effective and helps to reduce the angle of the spine to 22°.
When thoracic scoliosis is diagnosed, surgical treatment always reduces the costal hump. This is due to the fact that after the operation, the intercostal space expands, and the deformation decreases.
The most difficult is the surgical treatment of scoliosis among children, because their spine is constantly growing, and the use of metal structures can lead to "crankshaft" syndrome. That is why in the treatment of scoliosis in childhood, special dynamic structures are used that can be increased as the patient grows.
