In Greek there is the word "scolios", which translates as "crooked".With this word, the doctors indicate the curvature of the spinal column.Furthermore, not all curved, i.e. the lateral deviation of the vertical axis of the spine.The fact is that normally our backbone is not perfectly equal.The curves available in the front and rear (lordosis and cifosi) protect our spine from excessive loads while maintaining the body in a certain position when moving and transferred weights.The negative processes in our body develop only in cases where these kyphosis and lordosis are expressed in excess compared to the admissible rule.
The main problems
However, even a small degree of lateral curves (scoliosis) of the spine is always a pathology.And the point is not only in a cosmetic defect.Although a characteristic repulsive aspect with pronounced or progressive scoliosis is always a tragedy for a person who tries to live a full quality life.This is particularly true for young boys and girls.In fact, it is in the period for children and young people (up to 15-16 years) that a significant part of scoliosis is diagnosed.
The main problem is that due to a change in the configuration and volume of the chest with a pronounced side curvature, the internal organs always suffer (heart, lungs, stomach, liver, intestine, large vases).In men, physical effort tolerance decreases, women have problems with conception, pregnancy and pregnancy.In addition, very often the lateral deformation of the spine is only the surface part of the iceberg, which is a much more serious sign of a pathology: tumor, tuberculosis, endocrine disorders.
Reasons
So why is the spine deformed?Before answering the question, you should decide the types of scoliosis.At the base, scoliosis can be structural and non -structural.Structural scoliosis develops due to anatomical changes in the structure of the bone tissue of the vertebrae, as well as to the muscles, the nerves and the binding apparatus located nearby.These curvatures can be acquired and congenital and about a quarter of all diagnosed scoliosis represents the latter.
Among the main reasons for the development of structural scoliosis, they distinguish:
- Intrauterine development trees that lead to dysplastic disorders of one or more vertebrae
- Anomalies of the development of the congenital chest - lack of ribs, additional ribs
- Congenital pathology of the connective tissue - neurofibromatosis, Marfan syndrome
- Cerebral insufficiency due to the brain paralysis of children (cerebral paralysis), leading to a violation of the entertainment of some parts of the spine
- Osteoporosis (bone tissue) of the spine in the rachit, diseases of the paratyroid glands, lack of calcium intake with food
- Osteomyelitis of the vertebrae
- Dystrophic changes in cervical, chest and lumbar muscles
- Damage to tuberculosis to the vertebrae
- Spinal lesions
- Spine tumors.
Non -structural scoliosis, as follows by the name itself, are the lateral deviations of the axis of the spinal column with the unchanged structure of the vertebrae.As a rule, this scoliosis is often acquired with the exception of cases in which the curvature is of a compensatory nature with congenital anatomical defects of the pelvis or the lower limbs.The causes of this scoliosis are often:
- Pelvic lesions and lower extremities
- Congenital defects of the lower basin and ends
- Constant improper posture in schoolchildren
- Internal organs diseases with asymmetrically expressed pain syndrome
- Muscle inflammation (myosites)
- Burns, soft fabric scars on the one hand.
In these cases, to eliminate the curvature of the spine, it is sufficient to treat the underlying disease and therefore many non -structural scoliosis are easily reversible.In this regard, some doctors tend not to calculate non -structural deformations for scoliosis in general.
Recently, scoliosis development cases with unclear causes have become more frequent.This is idiopathic scoliosis so called.It occurs in young people, during the period of rapid growth of the body.In addition, girls suffer from idiopathic scoliosis several times more often than young people.Apparently, this is due to the relatively weak muscles of the back of the female, which is unable to enclose the spine in a full muscle frame.A unbalanced diet with low football salts and a general passion for young people with carbonated drinks plays a last role in the development of idiopathic scoliosis.As you know, carbon dioxide in bubbles and in orthophosphoric acid in synthetic inclusions contributes to the legging of calcium salts from the body.
Variety and degrees
Depending on the location, scoliosis can be cervical, chest, lumbar or mixed (cervical, lumbosacral).It is possible to have one or more curved arches.In this regard, scoli -shaped scoliosis are distinguished (with 1 arch), in the shape of S (with 2 arches) and in the shape of Z (with 3 arches).Most likely, the presence of 2 or 3 arches is compensatory.With C scoliosis, the axis of the spinal column differs.In an attempt to compensate for this, the spine folds in the opposite direction.In this regard, scoliosis is divided into compensated and not compensated.In the compensated spinal curvature, a vertical line lowered by the seventh cervical vertebra passes through the fold between the buttocks.
The curvature of the spine is often combined.For example, in the thoracic region, in addition to the lateral curvature, pathological cifosis or simply a hump is noted.In these cases, speaking of thoracic cyphospcodes.Furthermore, with large degrees of scoliosis, in addition to the lateral movement of the vertebrae, Thuria is observed.In a literal translation, this means torching.In fact, with many scoliosis, the vertebral bone tissue is twisted along the vertical axis.
Depending on the size of the corner of the bow of the curvature, 4 degrees of scoliosis are distinguished:
- 1 degree- The corner of curvature does not exceed 10 degrees.Asymmetry by eye is practically not determined.The curve, the inequal level of the shoulder belt, pay attention.
- 2 degrees- The corner of curvature ranges from 11 to 25 degrees.To this extent, the vertebrae are already noted.There is an asymmetry of the shoulder belt and the pelvis that is visible on the eye.Due to pathological muscle tension, a muscle roller is formed in the lumbar region from the concave side and in the chest area with a convex.
- 3 degrees- Wirtification ranges from 26 to 50 degrees.Visible deformation of the chest - western of the intercostal spaces c on the concave side of the curvature and swelling with convex.Weakening of the abdominal press, the formation of an internal hump.
- 4 degrees- The corner of curvature exceeds 50 degrees.A cosmetic defect and all previous signs are expressed.Low tolerability even of small physical efforts.In addition to the musculoskeletal system, the internal organs suffer.
The corner can vary depending on the position of the body, while stable and unstable scoliosis is distinguished.With unstable scoliosis, it decreases in the lying position when the load on the spinal column decreases.With a stable curvature of the spine, this value remains unchanged.
Symptoms
Recently, orthopedists often use the term "scoliotic disease".And they indicate a complex of negative changes that occur in the body during the curvature of the spine.As a rule, scoliotic disease develops in childhood and adolescence, during the formation of the musculoskeletal system.At the moment, there is a high probability that Scoliosis progresses.
Apparently, intervertebral discs play an important role in increasing the corner of curvature.With a lateral movement, the disc undergoes unequal pressure from vertebral bodies.On the concave side, this pressure is greater, with a convex - less.As a result of this, the disc is consumed even more by scoliosis, a pathological muscle tension is created (muscle roller) and the twist of the vertebrae - all this leads to the appearance of disk hernias and to a further increase in the corner of curvature.
Together with the spine with a scoliotic disease, the chest changes secondly.The hump is formed at the rib so called - on the convex side of the curvature, the intercostal spaces expand and, from the contrary - on the contrary, they are sown.With the scoliosis of the 4th degree, the deformation of the chest is thus pronounced that the lower ribs on the side of the curvature are in contact with the rowing of the iliac bone.
Due to the serious deformation of the chest, an excursion in all respects is difficult during breathing.Consequently, the body with severe scoliosis does not receive the required quantity of oxygen: the chronic hypoxia thus called is developed with a violation of all metabolic processes in the body.The pathology is aggravated by the fact that the internal volume and the shape of the chest cavity change.For this reason, blood circulation through the pots is disturbed, the lungs suffer, the form of heart changes develops, chronic cardiovascular insufficiency develops.
Similar changes occur in the abdominal organs for lumbar and lumbosacral scoliosis.The stomach and intestine engines are reduced with subsequent enzymatic insufficiency of the digestive glands.All this aggravates only metabolic disorders.These violations often lead to the late sexual maturation of boys and girls.In addition, due to lumbar scoliosis, the pelvis is curved a second time.This creates problems for future mothers with gestation and pregnancy.
Diagnostics
The diagnosis of scoliosis, in particular great degrees, as a rule, is not difficult.To detect the deformation of the spine, a common visual examination is often sufficient.The visible curvature of the contours of the spine, the asymmetry of the shoulder belt, the corners of the shoulder blades, the secondary curvature of the pelvis and the shortening of the lower limb on the side of the curvature are noteworthy.
In the presence of at least one of these signs, the radiography of the spinal column is indicated.The X -ray determines the configuration, degree and location of the curvature.During the inspection and radiological examination, it is possible to establish whether scoliosis is compensated and stable.Recently, a qualitatively new method of research on the IMEGING of the magnetic resonance imaging of the spine (MRI) has been released, during which it is possible to obtain a three -dimensional image of the spine on the monitor screen.With significant curvatures, it is necessary to study the work of the internal organs: to perform a spirometry, electrocardiography and perform an ultrasound of the heart and internal organs.
Treatment
The treatment of scoliosis can be carried out both conservatively and promptly.Conservative methods include pharmacological treatment, massage, physiotherapy procedures and manual therapy.It should be borne in mind that the final formation of the spine ends at the age of 20 and, after this age, the correction of the curvature is almost impossible.With 1-2 degree scoliosis, efforts aim to reach the initial and normal configuration of the spine.With the pronounced scoliosis of the 3rd - 4th degree, this is unattainable, the main thing here is to stabilize the spine and prevent scoliosis progression.
Medicines (chondroprotectors, vitamins, general strengthening drugs) in the treatment of scoliosis play only an auxiliary role.To strengthen the muscles, remove the muscle roller and even largely to stabilize the spine with the help of massage and manual therapy.A good effect is given by physiotherapy exercises.But here, with inadequate physical effort, the instability of the spine has improved and Scoliosis progresses.Therefore, a series of exercises is developed for each patient individually, taking into account the location and severity of the curvature.With a great degree of scoliosis, running, force exercises, jumps, outdoor games are contraindicated.
A very good result provides a correction by position: the optimal pose that contributes to the normalization of posture is created.For this, special devices are used, orthopedic cribs in which young patients spend a significant part of their time.With the ineffectiveness of the conservative measures, the progression of the curvature and surgical treatment aimed at stabilizing the spine is indicated.The surgical correction is not shown in early childhood, it is carried out in adolescence, when the formation of the spine is almost completed.