About the disease
Scoliosis, which does not cause physical discomfort, as well as scoliosis, causes a number of problems in the spine and adjacent organs, is distributed both in adults and children. Scoliosis is an unnatural curvature of the spine. When scoliosis, the trunk of the spine is distorted more or less in one direction or the other. The degree of scoliosis is characterized by the angle of distortion, measured in several projections (lateral, frontal). Conditionally divided:
- Scoliosis of 1 degree – less than 20 degrees
- Scoliosis of 2 degrees – 20-30 degrees
- Scoliosis of 3 degrees – 30-60 degrees
- Scoliosis of 4 degrees – more than 60 degrees
Some vertebrae can be displaced in relation to their natural state, while the line of hips and shoulders become uneven.
As a rule, scoliosis leads to deformation of the trunk of the spine and chest (ribs). Scoliosis may be C-shaped (in the form of the letter C) or S-shaped, may be complex combination: – in the form of a single curvature in one direction or the other (resembling the letter C form), or – in the form of two distortions – the primary and compensating secondary distortion (resembles letter S). Scoliosis develops more often between the upper part of the back (the thoracic region) and the lower part of the back (lumbar region). Or separately – in the upper or lower part of the back..
In the initial examination, scoliosis is classified according to the following characteristics:
- Form of distortion
- Distortion localization
- Distortion direction
- Distortion size
Causes of distortion, if possible. Distortions less than 20 degrees are considered moderate and make up 80% of cases of scoliosis. At distortions more than 20 degrees there is a necessity of medical supervision. Each recorded case of scoliosis requires a periodic review (once every six months or once a year). The review is conducted to monitor the rate and direction of the development of scoliosis.
Scoliosis is divided into structural or nonstructural. Unstructured (functional) scoliosis: unnatural curvature of the spine (without the twisting of the vertebrae). During the treatment of this type of scoliosis, the main role is given to the physiological cause of the formation of scoliosis (shortening of the leg, flattening, etc.) than the treatment of the spine. Structural scoliosis – spiral twisting of vertebrae, which leads to spiral twisting of the entire spine. During such twisting, the edges of one side of the chest are pushed outward so that the natural space between the ribs expands, and the shoulder extends outward (which leads to deformation of the chest, or the formation of a hump). The other half of the chest is twisted inside, compressing the ribs.
Other curvature of the spine, which occur locally or together with scoliosis, forms a hypercysophosis (an unnatural increase in bending by inverse rounding of the upper spine) and hyperlordosis (an increase in the flexure forward of the lower spine). Causes of Scoliosis In 80% of patients, the cause of scoliosis is unknown. Such cases are called idiopathic scoliosis (idiopathic – without any known cause). Idiopathic scoliosis may be associated with one or more hereditary factors not yet studied, more often in the maternal line. However, the degree of scoliosis may differ from one family member, proving the presence and other factors that influence the formation and development of scoliosis.
Among them: Physical deviations. Some common but uneven physical activity can cause imbalance in the musculoskeletal system, which can lead to distortion of the spine. Some studies show that muscular imbalance around the spine can make children susceptible to pathological changes in the back during growth and eventually become a cause of muscular dystrophy or cerebral palsy. Problems of coordination. Some experts find a connection between inherited defects in the perception or coordination and distortion of the spine in children with scoliosis. Biological reasons. Currently, the influence of biological factors on the formation of scoliosis is studied. An elevated level of enzymes can cause disturbances in the components of the intervertebral discs, which leads to the degeneracy of such disks. Changing the protein that binds to calcium affects the deep muscle of the back and pulls out the muscle tissue by forming microspasm (trigger point), local seizure. Congenital scoliosis is due to congenital spinal deformities, such as the absence or splinting of the vertebrae. Problems with the kidneys, especially when there is only one kidney, are often compared with congenital scoliosis. The condition is usually evident in children aged 2 or 8 to 13, when the spine begins to grow faster, creating additional stresses on the vertebra. It is very important to begin to diagnose and monitor such deformations as early as possible, as they can progress quickly.
Neuro-muscular scoliosis may occur as a result of neuromuscular pathologies. In this type of scoliosis problem is the formation of the bones of the spine itself. The bones of the spine may not be fully formed or not separated from each other during the period of prenatal development. Under such conditions, C-shaped curvature of the spine is more often formed, in which weak muscles can not hold it directly..
In particular, neurotropic scoliosis is formed:
- as a result of traumatic damage to the spine
- as a result of neurological or muscular disorders
- as a result of cerebral palsy
- as a result of a craniocerebral injury
- as a result of poliomyelitis
- as a result of a defect of the central nervous system
- as a result of back muscle dystrophy
- as a result of trauma of the spinal cord
- as a result of myopathy (muscle damage)
Patients with this type of disease often have serious complications, including increased risk of skin ulcers, lung problems that are accompanied by severe pain.
Adult scoliosis (dystrophic scoliosis). Unlike other forms of scoliosis that are observed in children and adolescents, dystrophic scoliosis occurs in the elderly. One of the reasons is the consequences of child scoliosis, which was not diagnosed on time. Other causes are caused by changes in the spine due to arthritis, spondylosis, weakening of the ligament and other soft tissues of the spine, in conjunction with the formation of bony growths (osteophytes). The curvature of the spine may also depend on osteoporosis, compressive spine fractures, and the degeneration of the intervertebral discs. Osteoporosis is a serious problem for many people in the elderly. It is not a major risk factor for scoliosis, but can make a significant contribution to the formation of the disease. Other causes that affect the formation of scoliosis: Tumors, growths, or other small tumors on the vertebral column. These back abnormalities can play a much larger role in the formation of scoliosis than previously thought. Stress is transmitted due to fractures or hormonal disorders that affect the growth of bones in young, professional athletes. Turner’s Syndrome, Genetic Disease in Women, Implicated in Physical and Reproductive Development.
Symptoms of Scoliosis
The most common symptom of scoliosis is the apparent curvature of the spine. Scoliosis often occurs painlessly. Distortions themselves can be so insignificant that even parents and friends can not notice them in everyday life. Symptoms can be overlooked until they become more serious forms. A distortion of the back may appear in the school scoliosis examination. Complications with scoliosis occur as a result of distortions, which gradually deepen. Without timely treatment of complications with scoliosis, the consequences may be manifested by the following symptoms:
- Permanent back pain
- Inflammation of the bone (vertebrae)
- Difficulty breathing (when the chest is compressed due to the rotation of the edges and the spine)
- Damage (deformation) of the heart and lungs caused by deformations of the chest
- Susceptibility to pulmonary infections (such as pneumonia)
- Back pain during pregnancy (due to increased pressure on the spine)
- Increased risk of bone loss (osteopenia / osteoporosis)
- Absence of limb sensitivity that imbalances motor skills
What needs to be addressed in order to identify / diagnose scoliosis at an early age:
- The head is slightly in the direction of the pelvis axis
- Speakers are unnaturally outside the shoulder blades
- One thigh or shoulder above the other, causing an uneven distribution of the body relative to the horizontal axis
- Uneven neckline in a balanced position of the body
- Uneven waistline
- Permanent inclination of the body to one side
Because of scoliosis in girls, the chest may be different in size and location. One side of the back is above the other (due to spasmodic muscles or manifested outside the edges) when the person bends, keeping the knees and hands falling down equal.
Diagnosis of scoliosis
If you suspect scoliosis, you should sign up for a doctor for review. During a visit to a doctor it is necessary to answer questions concerning the history of the origin and development of scoliosis in the family, the type of pain that accompanies scoliosis, other medical problems that could have been one of the causes of scoliosis. Physical examination involves the study of distortions of the spine on the sides, front and back. If you lean forward, trying to reach your floor with your fingers (with your knees remaining equal), the distortions become more obvious. The doctor also notes the symmetry of the body, in which the hips and shoulders should be at the same height. Any skin changes will also be made to help diagnose scoliosis as an innate defect. The doctor can also check the range of movements, muscular strength and reflexes. Over the years, the probability of developing scoliosis increases. Therefore, the physician can measure the height and weight of a person for comparison with subsequent visits in the future.
The degree of scoliosis and, accordingly, the need for treatment, as a rule, are determined by two factors:
- Degree of curvature of the spine (scoliosis is diagnosed when distortion = 11 degrees or more)
- Pivot Angle (PA)
Both factors are measured in degrees and, as a rule, are interconnected. For example, a person with curvature of the spine at 20 degrees, as a rule, has a pivot turn of 5 degrees. These two indicators really give rise to the preparation of treatment recommendations, as most people with a degree of distortion of 20 or less degrees do not require medical treatment. As long as the curvature does not reach 30 degrees, and the angle of rotation of the pillar is 7 degrees.
Tests for the determination of scoliosis: The patient goes to the toes and then jumps up and down on one leg. This test demonstrates the strength of the legs and the ability to balance. The doctor examines the length of the leg and looks for hard tendons on the back of the leg. Rigid tendons can cause uneven legs or problems with your back. The doctor checks for the presence of neurological disorders, checking reflexes, nervous feelings and muscle functions. At the same time, when the doctor diagnoses scoliosis, he may be asked to come back for an additional examination in a few months to find out if there is any change or may impose an additional survey. This can be X-ray images of the back. If the doctor believes that any changes have occurred in the functions of the nervous system, he may prescribe other tests of the spine display: including MRI (magnetic resonance imaging) or CT (computed tomography) to further study the bones and nerves of the spine . Despite the fact that the measurement of distortions and spinal curvatures are very effective diagnostic measures, no test at the moment can determine the progress of scoliosis in the future.
Treatment for scoliosis
Treatment depends on the degree of distortion and progression of the curvature of the spine and adjacent bones. The development of some types of scoliosis is more likely to lead to complications of the disease, therefore the correct diagnosis of the type of disease is of great importance. In “Spine Ambulatory” you correctly diagnose the type, degree of disease and determines the necessary method of rehabilitation. There are three most common categories of treatment: surveillance, active rehabilitation, kinesiotherapy and curative gymnastics, the use of corrective corsets (fixing corsets) and surgical intervention. In the “Spine Ambulatory” you will be assisted without medication and surgery.