Scoliosis (curvature of the spine) relates to the common states. In the mass screening some degree of scoliosis is found in 10-28% of the population. Most often it is a small degree of curvature, up to 20 degrees. The number of patients with scoliosis is growing. Perhaps this is due to changing lifestyles. More people sitting there. Physical activity is insufficient to maintain the good condition of the muscular system. Scoliosis is curvature of the spine to one side more than 10 degrees.
Scoliosis are:
morphological or structural
functional.
Morphological abnormalities caused by scoliosis of the spine and its supporting structures (ligaments and muscles). Most often, such congenital scoliosis. The nature of the anomalies may be different: fusion of two or more vertebrae, the presence of additional undeveloped vertebrae, fusion of ribs, hypoplasia of handles, processes of the vertebrae. The greatest number of anomalies found in the lumbosacral spine. This is spina bifida, the presence of additional lumbar, or fusion of the fifth lumbar vertebra with the sacrum, especially if such a unilateral fusion.
Spinal deformity occurs first on one limited area, where there is an anomaly. Then, compensatory, the formation of protivodugi another department. For scoliosis can cause infectious processes in the spine, polio, myopathy, cerebral palsy, rheumatoid arthritis, rickets.
Functional scoliosis develops as a result of exposure to causes not directly related to the spine. This shortening of one leg, hip dysplasia, malformations of the pelvis. However, the cause of scoliosis can be detected only a small number of patients. In 80-90% of the cause of the disease remains unknown and this is called idiopathic scoliosis. There are many theories and assumptions, why develop idiopathic scoliosis, but the final cause of idiopathic scoliosis is not yet clear.
The disease begins gradually and imperceptibly. Patients themselves, usually children do not notice the distortion. Pain in the back occurs when the scoliosis is already there. The pain occurs during exercise and decreases or disappears after rest or in repose. In children, pain might not be. Without treatment, scoliosis gradually progressed. With the development of severe scoliosis in patients with respiratory disorders may occur, disorders of the nervous system.
Diagnosis is established by examination of the patient. The inspection shall be performed in the supine position, standing, sitting. Change the length of the legs, investigate spinal mobility in all departments. In what direction is curved spine is determined by the direction of a more pronounced arc. X-rays are performed in the supine and standing positions, produce images with a special styling to create a specific image of projection spine, measure the angle of curvature.
Radiologically there are four degrees of scoliosis:
1 degree. The angle of curvature of the spine does not exceed 5 degrees. Clinically detected asymmetry of standing shoulder girdle, shoulder blades angles, lateral curvature in the thoracic region. Muscle spindle is found in the lumbar region, on the opposite side of the arc. Muscle tone the abdominal muscles and back muscles relaxed.
Grade 2. The angle of curvature of the spine from 6 to 25 degrees. The asymmetry of the shoulder girdle and the angles of blades increases. S-shaped spine is curved. If the patient is tilted, it becomes noticeable rib hump - protrusion of the chest next to the scoliotic arch. The muscle spindle is even more pronounced.
3 degree. The angle of curvature of the spine from 26 to 80 degrees. When third-degree S-shaped scoliosis spinal deformity still more pronounced. The trunk is not configured correctly. When you angle the patient revealed marked rib hump. Broken pelvis distance.
Grade 4. The angle of curvature of the spine, more than 80 degrees. In the fourth degree all manifestations pronounced. Torso and thorax deformed, the internal organs were removed from its normal position. There may be a spinal cord compression with the formation of paralysis. The high degree of scoliosis can lead to compression of the lungs with the development of pulmonary hypertension, respiratory and cardiovascular failure. Disrupted almost all internal organs including the gastrointestinal tract and urinary system.
Treatment of scoliosis.
Treatment of scoliosis should be started as soon as possible. In children, it measures the normalization of life. Assigned to physiotherapy, swimming, massage. These methods achieved the normalization condition and tone muscles in the back and abdomen, forming the correct posture. In the second degree of scoliosis requires a special physiotherapy, fiziotrening, wearing a soft corset is appointed.
Rapid progression of scoliosis is an indication for referral to a boarding school for the treatment of children with lesions of the musculoskeletal system, or orthopedic department of hospitals. Lack of effect and the progression of scoliosis is an indication for surgical treatment. There are many methods of surgical treatment, but no one technique does not lead to complete recovery, so long as the main treatment is conservative.
