What is scoliosis - types, degrees, treatment. Scoliosis: causes, symptoms, treatment Pronounced scoliosis

Scoliosis- a condition in which the patient has a lateral curvature of the spine. With this pathology, the spine has the shape of the letter C or the letter S. As a rule, this condition develops in children aged 6 to 15 years. Scoliosis is more commonly diagnosed in girls. As a rule, the disease proceeds in a mild form, so it does not cause particularly unpleasant sensations in the patient. If the spine is curved very strongly, then a person may periodically experience back pain, breathing becomes difficult.

Causes of scoliosis

Scoliosis of the spine occurs in a person due to several reasons. First of all, curvature of the spine can manifest itself as a consequence congenital developmental defects , diseases like central , and, as well as some other diseases.

With rickets, a child shows a strong load on the spine, especially if he is constantly in the wrong position when worn on one arm or when the baby is sitting early.

Very often, the reasons due to which the development of scoliosis began in a child cannot be established. In this case, it is about idiopathic scoliosis . In this case, scoliosis, as a rule, develops even before puberty, and there are no changes in the bones at the site of deformation.

Static scoliosis develops in a child if there is a shortening of one leg, due to which the pelvis is constantly located obliquely. In addition, students often develop "habitual" scoliosis , as a consequence of a prolonged load on the spine due to sitting at low desks or in the wrong position.

A higher risk of developing scoliosis is observed in children in whose family there were cases of this disease. Scoliosis in adults is often associated with age-related degenerative changes with or.

In addition, as the causes of scoliosis, both the environmental factor and the upright posture of a person as such are called. Therefore, there is no clear single cause of this pathology.

Features of the course of scoliosis

As a rule, scoliosis of the spine develops in children at a time when they are growing most intensively. Sometimes children's scoliosis progresses with age, which can be easily judged even from a photo. Therefore, it is very important to identify the symptoms of curvature of the spinal column as early as possible and take all measures to help eliminate the problem. If there is only a slight curvature of the spine, then the patient does not require therapy. However, he must clearly know what scoliosis is, what are the contraindications for this disease, and regularly undergo examinations by a specialist. As a rule, treatment (corset, surgery, special exercises) is necessary for a relatively small number of people with an s-shaped or c-shaped spine. However, prevention is very important in each case of the disease, since in the future the consequences of the disease can manifest themselves as serious problems. For example, yoga is recommended for mild scoliosis.

Scoliosis in adults and children can be suspected if a person has one hip or shoulder visually located higher, one shoulder blade protrudes more clearly than the second, the head is not located in the center of the shoulders. If a person with scoliosis leans forward, then the ribs on one side are higher than on the other. The left or right side will be higher, depending on whether the patient developed left-sided or right-sided scoliosis.

Curvature of the thoracic spine progresses more actively than lumbar scoliosis. Therefore, the types of scoliosis are the moment that is especially important in the process of establishing a diagnosis.

Young men with a curvature of the spine are separately interested in the question of whether they are taken into the army with such a diagnosis. Only a specialist can determine the degree of curvature and, therefore, answer this question. However, as a rule, the army is available to those who are diagnosed with a mild degree of illness.

Types of scoliosis

Doctors distinguish several different types of scoliosis in children and adults. At idiopathic scoliosis pathology is not associated with other diseases or disorders. In this case, we are talking about the fact that the causes of scoliosis are unknown. In turn, three main types of idiopathic scoliosis will be defined.

At infantile scoliosis the disease develops in children after the age of two. In most cases, this type of scoliosis heals spontaneously. This type of disease is relatively rare.

Juvenile idiopathic scoliosis in children manifests itself in the period from two to ten years of age. Whether treatment is necessary in children of this form of scoliosis is determined by the doctor on an individual basis. But this form is also rare.

Manifestations adolescent idiopathic scoliosis are noted in early adolescence, moreover, girls get sick more often with just such a form of the disease that requires treatment.

In addition to idiopathic, other types of this disease are also determined. At functional scoliosis the spine is in normal condition. In this case, the development of curvature occurs due to the presence of other pathologies in the patient's body (muscle spasm in the back, different lengths of the lower extremities).

At neuromuscular scoliosis problems appear at the stage of formation of the spine. In some cases, the bones of the spine simply cannot fully form, sometimes they are not completely separated from each other even during fetal development. The disease develops in people suffering from cerebral palsy , muscular dystrophy and others. If the spine is already curved at birth, then we are talking about congenital scoliosis. In this case, more serious treatment is often required than in other forms of scoliosis.

Degenerative sclerosis predominantly older people are affected. Changes in the spine in this case occur as a result of inflammatory processes in the joints of the spine. Scoliosis is manifested as a consequence of the weakening of the soft tissue ligaments and the growth of bone tissue. Also, curvature of the spine can occur as a consequence osteoporosis , disc degeneration , vertebral fractures .

Scoliosis degrees

The degree of scoliosis is determined taking into account the magnitude of the curvature of the spine in a certain direction.

Scoliosis 1 degree is diagnosed in a patient if it deviates from the axis by less than 10 degrees. A slight deviation of the spine of a few degrees exists in most people. Therefore, the first degree of scoliosis is defined as a variant of the norm.

Scoliosis 2nd degree is determined if the spine is deviated from the axis to the left or right by 11-25 degrees. In this case, correction is already required, since in the future scoliosis may progress, and the situation becomes more complicated. Patients with such a diagnosis are most often prescribed special therapeutic exercises.

At scoliosis 3 degrees the spine deviates already by 26-50 degrees. Scoliosis 4 degrees determine if the spine deviates more than 50 degrees. In the last two cases, scoliosis is very difficult to treat.

Complications of scoliosis

In the presence of a curvature of the spine in a person, a number of concomitant ailments may develop over time: osteochondrosis , gastrointestinal diseases , genital area , respiratory system and others. With scoliosis in a child, as a rule, it is weakened. Over time, hormonal disorders, menstrual irregularities in girls may appear. In addition, later it will be difficult for a woman with a curved pelvis to become pregnant, endure and give birth to a baby.

Scoliosis diagnosis

Initially, the diagnosis of scoliosis involves a thorough external examination of the patient. In order to determine the disease, the patient is asked to lean forward, since it is in this position that the manifestations of scoliosis are best seen. You need to bend at the waist and lean forward with arms hanging freely. The palms must be brought together. In this position, asymmetry in the height of the ribs and back is noticeable in patients with scoliosis. The doctor also pays attention to the condition of the patient's skin, since if there are changes, birth defects can be assumed. If necessary, the amplitude of movements, reflexes, muscle strength are checked.

With severe scoliosis, in order to clarify the diagnosis, an X-ray examination is performed, according to the results of which it is possible to determine the angle of curvature of the spine.

If the disease progresses very quickly, then in order not to expose the patient to frequent radiation, the method of scoliometry, a three-dimensional sensory examination of the spine, is used.

The doctors

Scoliosis treatment

Treatment of scoliosis is carried out after a thorough study and determination of the degree of development of the disease. So, if a patient is diagnosed with stage 1 scoliosis, then therapy is not required. With scoliosis of the 2nd degree, special exercises are practiced for the treatment of scoliosis. It is important that physical exercises for scoliosis are selected by a specialist who is well aware of the individual characteristics of the patient's body. The complex must be performed regularly, for a long time. Therapeutic gymnastics for scoliosis includes exercises for the back, as well as specially selected exercises for correcting the spine.

Stage 3 scoliosis in adults and children progresses relatively quickly, so the doctor chooses a treatment tactic that allows you to stop progress as soon as possible.

In modern medicine, three categories of treatment are practiced: observation , conservative treatment aimed at general strengthening, as well as surgical treatment .

When determining how to treat scoliosis, the doctor must take into account the form of this disease. So, with functional scoliosis, it is important to eliminate the cause that provoked its development. For example, with a difference in legs, this can be corrected with the help of special shoes.

In some cases, it is advisable to use a special corset that can be worn at home. Corseting allows you to create a normal symmetry of the patient's body and eliminate the displacement. However, when deciding how to correct the spine, one must take into account that wearing a corset requires a lot of patience and must be continued for a long period. Wearing a corset is prescribed mainly for children. Stop it when the period of active growth ends. To get the effect, the corset must be worn for at least 16 hours a day.

When treating with the help of wearing a corset, the patient is prescribed exercise therapy with scoliosis. Prolonged wearing of a corset leads to muscle atrophy, and it is physiotherapy exercises that can prevent the return of scoliosis after stopping wearing a corset and strengthen the muscles. Swimming is also useful for scoliosis. In some cases, the specialist advises using a special massage for scoliosis as an auxiliary method. Physiotherapy, electrical stimulation of the back muscles can also be used. Taking vitamins is practiced.

If a complex form of the disease is diagnosed, then the doctor, when deciding how to cure scoliosis, may insist on surgical intervention.

During the operation, the spine is straightened, after which it is fixed with special metal rods.

Prevention

Patients with scoliosis should follow some rules that allow them to lead a full life and not aggravate the disease. In particular, too strong physical exertion should not be allowed, since with scoliosis there is always an additional load on the internal organs. It is best to perform special exercises prescribed by a doctor as a physical activity.

In order to prevent the development of scoliosis, from early childhood, the child must be taught to monitor the correct posture. It is desirable that a child sleeps on a flat, hard bed from childhood, learns to sit correctly, without bending his back.

You should always make sure that the load on the spine is not excessive. To this end, the child should replace the briefcase with a knapsack.

A healthy lifestyle, walking, being outdoors, physical activity are effective preventive measures. It is advisable to undergo preventive examinations from time to time so as not to miss the onset of the disease.

List of sources

• Zaidman A.M. Idiopathic scoliosis. Morphology, biochemistry, genetics. Novosibirsk, 1994;
• Mikhailovsky M.V., Fomichev N.G. Surgery for spinal deformities. Novosibirsk, 2002;
• Shapovalov V.M., Nadulich K.A., Dulaev A.K. and other Deformities of the spine: Textbook. St. Petersburg, 2000;
• Surgery for idiopathic scoliosis: immediate and long-term results / Ed. M.V. Mikhailovsky. Novosibirsk, 2007.

Scoliosis is an abnormal curvature of the spine. The normal spine has natural curves that make the lower back curve inwards. Scoliosis usually causes deformity of the spine and chest. In scoliosis, the spine curves from one side to the other to varying degrees, and some of the vertebrae may rotate slightly, making the hips or shoulders uneven.

Curvature of the spine can develop as follows:

C-shaped scoliosis. The simplest type of scoliosis. It is characterized by the presence of one arc of curvature. C-shaped scoliosis is the most common. It is detected quite easily: the patient is asked to bend over, while an arc of curvature in the form of the letter C is visible on his back;

S-shaped scoliosis. This form of scoliosis is characterized by the presence of two arcs of curvature, as a result of which the spine takes an S-shape. One arc is the main, scoliotic. The second arc is compensatory. It occurs in the overlying spine in order to align the position of the body in space. For example, if a curvature of the lumbar spine develops to the right side, then over time there is a curvature in the thoracic segment, but to the left. This scoliosis is diagnosed during a doctor's examination and with the help of X-rays.

- Z-shaped scoliosis. If the spine forms 3 bends at once, such scoliosis is called Z-shaped. The third arc is less pronounced than the other two. This is the most rare and severe form of pathology, which can only be detected with the help of x-rays.

In addition to the form of deformation, the spinal column can be curved to the right or to the left. In this regard, right-sided and left-sided scoliosis are distinguished. With S-shaped scoliosis, the deformity arcs are directed in different directions. In Z-shaped scoliosis, the upper and lower arches are directed in one direction, and located between them - in the opposite direction.

Scoliosis can also occur in adults, but most of all it is diagnosed for the first time - in children aged 10-15 years. About 10% of adolescents have some degree of scoliosis, but less than 1% develop scoliosis that requires treatment.
Among the adult population, there may also be scoliosis, which is not associated with physical disabilities. There may be scoliosis associated with spinal problems.

Other spinal anomalies that can occur alone or in combination with scoliosis include: hyperkyphosis (or kyphotic posture - deformity of the thoracic spine with a posterior, backward bulge) - an abnormal exaggeration with reverse rounding of the upper spine, and hyperlordosis (increased forward curvature of the lower part of the spine, which is also called "pathological strengthening of the lumbar lordosis"; lordosis - the curve of the spine, facing the bulge forward).

Scoliosis usually develops in the area between the upper chest and the lower back (lower back). It can also only occur in the upper or lower back. The doctor tries to define scoliosis using the following characteristics: the shape of the curve (curvature), its location, direction, magnitude, and causes, if possible.

The severity of scoliosis is determined by the degree of curvature of the spine and the angle of rotation of the trunk (ATR), which is usually measured in degrees. Curves less than 20 degrees are considered soft and account for 80% of scoliosis cases. Curves progressing more than 20 degrees require medical attention. However, as a rule, periodic monitoring is carried out in such cases.

Brief anatomical information about the spine

- Spine. The spine is a column of small bones (vertebrae) that support the entire upper body. The vertebrae are grouped into three sections:

• 7 cervical vertebrae (C) that support the neck;
• 12 thoracic or thoracic (T) vertebrae that connect to the chest
• The 5 lumbar (L) vertebrae are the lowest and the largest bones of the spine. Most of the body weight is carried by the lumbar vertebrae.

The number indicates the location of the vertebra within its area. For example, C4 is the fourth vertebra down in the cervical region, T8 is the eighth thoracic vertebra.

Sacrum. Below the lumbar region is the sacrum, a shield-shaped bony structure that connects to the pelvis at the sacroiliac joints. At the end of the sacrum are 4 tiny vertebrae known as the coccyx. All vertebrae form the spinal column. In the upper torso, the vertebral column is usually curved outward (kyphosis), while the lower back is curved inward (lordosis).

- Disks. The vertebrae in the spine are separated from each other by small cushions of cartilage known as "intervertebral discs". Inside each disc is a jelly-like substance, the nucleus pulposus, surrounded by a tough annulus fibrosus. The disc is 80% water. This structure makes the discs elastic and strong. They do not have an independent blood supply, and their nutrition is supported by nearby blood vessels.

- Spinous processes. Each vertebra in the spine has a series of bony structures known as "spinous processes". The spinous and transverse processes act as small levers for the muscles of the back, allowing the spine to be flexible.

- Spinal canal. Each vertebra and its spinous processes surround and protect a central arched opening. These smooth arches run down the spine and form the spinal canal, which encloses the spinal cord and the nerves of the central trunk that connect the brain to the rest of the body.

Characteristics of scoliosis

- Definition of scoliosis by the shape of the curve. Scoliosis is often classified according to the shape of the curve, either structural or non-structural.

- Definition of scoliosis by its location. The location of the structural curve is determined by the location of the apical vertebra. This is the bone at the highest point (apex) in the dorsal hump. This particular vertebra also rotates very hard during the disease.

- Definition of scoliosis in its directions. The direction of the curve in structural scoliosis is determined by the convexity (rounding) of the side of the curve in turns to the right or left. For example, a doctor will diagnose a patient with right thoracic scoliosis if the apical vertebra (located at the apex, facing up) is in the thoracic spine (upper back) and the curve curves to the right.

- Definition of scoliosis by its size. The magnitude of the curve is determined by measuring the length and angle of the curve on the x-ray image.

- Structural scoliosis. The vertebrae of rotation and twisting of the spine are curved in different directions. In twisting, the ribcage is pushed outward on one side, so that the space between the ribs expands and the shoulder blades protrude, producing a chest deformity or hump. The other half of the chest twists inward, squeezing the ribs.

- Nonstructural scoliosis. Non-structural scoliosis is a simple lateral deviation of the spine, without structural anatomical changes in the vertebrae and the spine as a whole, in particular, there is no fixed rotation of the spine, characteristic of structural scoliosis.

Causes of scoliosis

- Physical abnormalities. Physical abnormalities can cause imbalances in the bones and muscles, leading to scoliosis. Research shows that imbalances in the muscles surrounding the vertebrae can lead to changes in posture in children as they grow.

- Problems of coordination. Some experts point to inherited coordination defects, which in some children can cause the development of scoliosis in the spine.
There may be other biological factors as well.

Causes of scoliosis in adults

Adult scoliosis has two main causes:

• development and progression of children's scoliosis;
• degenerative scoliosis. This is a condition that usually develops after the age of 50. Under this condition, the lower part of the spine tends to suffer from disc degeneration. Osteoporosis, a serious problem for many older people, is not a risk factor for the onset of a new scoliosis, but it can be a factor in exacerbating an existing scoliosis. However, in most cases, it is not known why scoliosis occurs in adults.

Conditions affecting the spine and surrounding muscles

Scoliosis can be the result of various conditions that affect the bones and muscles associated with the spine. They include:

• tumors, injuries or other changes in the spine. These pathologies of the spine can play a large role in the occurrence of cases of scoliosis;
• stress, fractures and hormonal disorders that affect bone growth in young people and professional athletes;
• Turner syndrome - a genetic disease in women that affects physical and reproductive development;
• other diseases that can cause scoliosis are Marfan's syndrome, Aicardi's syndrome, Friedreich's ataxia, Albers-Schonberg's disease, rheumatoid arthritis, Cushing's syndrome, and osteogenesis imperfecta;
• spina bifida is a congenital disorder in which the spine and spinal canal do not close after birth. In severe cases, this can lead to spinal cord injury.

Risk factors scoliosis

- Risk factors for idiopathic scoliosis. Idiopathic scoliosis, the most common form of scoliosis, occurs most often during a person's growth period during adolescence (mainly in children 3 to 10 years of age). Soft curvature (up to 20 degrees) is observed approximately equally in girls and boys, but curve progressions occur 10 times more often in girls. And other factors must be present for scoliosis to occur. A risk factor that affects women is the onset of menstruation, which can prolong the period of bone growth, thereby increasing the likelihood of developing scoliosis.

- Risk factors for curvature progression. Once scoliosis is diagnosed, it is very difficult to predict who is at highest risk for curve progression. About 2-4% of all adolescents develop curves of 10 degrees or more, but only about 0.3-0.5% of adolescents have curves greater than 20 degrees, requiring medical attention.

- Medical risk factors. People with certain conditions that affect the joints and muscles are at higher risk for scoliosis. These diseases: rheumatoid arthritis, muscular dystrophy, poliomyelitis, cerebral palsy. Children who undergo organ transplants (kidney, liver, and heart) are also at increased risk.

Professional risk factors. Scoliosis can also be evident in young athletes, with a prevalence of 2-24%. The highest rates were observed among dancers, gymnasts and swimmers. Scoliosis can be partly due to weakened joints, delayed puberty (which can lead to weakened bones), and stress on the growing spine. A higher risk of scoliosis is observed in young people who actively participate in sports and give an uneven load on the spine. Sports that put an extra heavy load on the spine are: figure skating, dancing, tennis, skiing, javelin throwing, etc. In most cases, scoliosis occurs in minors. Therapeutic exercise offers many benefits for young and old people, and may even help patients with established scoliosis.

Types of scoliosis

- Idiopathic scoliosis. In 80% of patients, the cause of scoliosis is unknown. Such cases are called idiopathic (“no known cause”) scoliosis. Idiopathic scoliosis may be associated with hereditary factors.

Idiopathic scoliosis can be classified according to the age of the patient. Age at onset may also determine the approach to treatment. The age classification is as follows:

• children: up to 3 years;
• minors: from 4 to 9 years;
• teenagers: 10 years old.

Idiopathic scoliosis may be initially diagnosed in adults by evaluation of other complaints or disorders, although the curve may be small.

- Congenital scoliosis. Congenital scoliosis is caused by a congenital deformity of the spine, which can lead to missing or fused vertebrae. Kidney problems, especially in those with only one kidney, often coincide with congenital scoliosis. The disease can usually appear at any age, but most often, congenital scoliosis occurs in children aged 8-13 years, when the spine begins to grow faster, placing additional stress on unhealthy vertebrae. It is important to diagnose and monitor such curvature as early as possible, as it can progress rapidly. Early surgical treatment to prevent serious complications - before the age of 5 years - may be important for many of these patients.

- Neuromuscular scoliosis. Neuromuscular scoliosis can result from a variety of causes, including:

• traumatic injuries of the spine;
• neurological or muscular disorders;
• cerebral palsy;
• traumatic brain injury;
• poliomyelitis;
• myelomeningo (defect of the central nervous system);
• spinal muscular dystrophy;
• spinal cord injury;
• myopathy (muscle damage).

These patients often have serious complications, including lung problems and severe pain.

Scoliosis is often asymptomatic. The curvature itself may be too slight to be noticed even by observant parents. Some parents may notice these kinds of abnormal postures of their growing child:

• slouch;
• inclination of the head that does not coincide with the level of the hips;
• protruding and asymmetrical blades;
• one hip higher than the other or one shoulder higher than the other;
• chest deformity;
• support on one side more than on the other;
• breasts of unequal size in girls during development;
• one side of the upper back is higher than the other, and when the child bends over, the knees are together;
• back pain, increased pain after a short walk or standing.

Scoliosis can be suspected when one shoulder is higher than the other - this means that scoliosis develops in the spine at the level of the pelvis. Treatment for this type of scoliosis may include surgery or a brace. Treatment is determined by the cause of the scoliosis, the size and location of the curve, and the patient's stage of bone growth.

With more severe scoliosis, fatigue may occur after prolonged sitting or standing. Scoliosis, caused by muscle spasms or growths on the spine, can sometimes cause pain. Almost always, mild scoliosis causes no symptoms, and the disease is discovered by a pediatrician or screening.

Scoliosis diagnosis

The severity of scoliosis and the need for its treatment is usually determined by two factors:

• the degree of curvature of the spine (scoliosis is diagnosed when the curve is 11 degrees or more);
• the angle of rotation of the torso in degrees (ATR).

These two factors are usually related. For example, if a person has a curvature of the spine of 20 degrees, then, as a rule, the ATP will be 5 degrees. But patients usually do not need medical attention until the curve reaches 30 degrees and the ATP is 7 degrees.

- Medical checkup. Tilt test. Screening tests are used most often in schools and offices by pediatricians and primary care physicians. They are called "on the slope". The child leans forward, while his arms should hang out, his legs should be together, his knees should be straight. Any imbalance in the chest or other deformities along the back can be a sign of scoliosis. The structural scoliosis curve is more obvious when the child leans over. In a child with scoliosis, the examiner may observe an unbalanced chest - higher on one side than the other, or other deformities. Forward bend tests are not indicative of low back deviations, which are very common in scoliosis. Because the test misses about 15% of cases of scoliosis, many experts do not recommend it as the only method for screening for scoliosis.

- Physical tests. The patient walks on toes, then on heels, and then bounces on one leg. Such actions show leg strength and balance. The doctor checks the length of the legs and looks for stiff tendons in the back of each leg, which can cause uneven leg length or other back problems. The doctor also checks for neurological disorders by testing reflexes, nerve sensations, and muscle function.

- Definition of curvature achieved with a scoliograph. The scoliograph measures the top (highest point) of the upper curve of the back. The patient continues to bend along the curve until it becomes visible in the lower back (lower back). The top of this curve is also measured. Some experts believe that the scoliograph is a useful device for broad screening. Scoliometers, however, show chest distortion in more than half of the children, who have very slight curves. Therefore, they are not accurate enough to be used in treatment. If the results show deformity, then the patient will likely need an x-ray to determine the extent of the problem.

- Visualization. To date, imaging techniques are fairly accurate for detecting scoliosis in the upper back (thoracic region), but not in the lower back (lumbar region).

- X-ray. Currently, X-ray is the most effective method for diagnosing scoliosis. If screening indicates scoliosis, the child may be referred to a specialist who checks the child every few months with repeated x-rays and looks for progression. X-ray is also necessary for accurate diagnosis of scoliosis. It shows the severity of scoliosis and other pathologies of the spine, including kyphosis and hyperlordosis (an abnormal increase in lumbar lordosis). X-ray also allows you to determine whether the skeleton has reached maturity. Also, when the patient is leaning forward, x-rays can help distinguish between structural and non-structural scoliosis. Structural curves persist when a person leans over, while non-structural curves tend to disappear (muscle spasms or spinal masses can sometimes cause non-structural scoliosis).

- Magnetic resonance imaging (MRI). An MRI is quite expensive and is not used for initial diagnosis. MRI can, however, reveal brainstem abnormalities of the spinal cord, which some studies show these abnormalities may be more common in children with idiopathic scoliosis. An MRI can also be especially helpful before surgery to detect defects that could lead to potential complications.

- Determination of the end of curvature growth. Even if the curve is accurately calculated, it is still difficult to predict whether scoliosis will progress. Knowing the age of the child can be the first step in assessing the end of curvature growth. In addition, other methods can help predict the end of the growth stage. One method is called the "Riesser test". This is a test for the completion of tissue ossification, indicating the end of the growth of the spine, and hence the end of the progression of scoliosis. With the help of the Risser test, the growth time of the spine is determined, thereby specifying the period of possible progression of the disease. Scoliosis is one of those diseases in which the assessment of biological age is the most important component of diagnosis. The Risser method makes it possible to estimate the biological age by the degree of ossification of the ilium.

Scoliosis treatment

Treating scoliosis is not always easy. Some young people do not need treatment at all - only careful monitoring. There are several options for treatment, including staples and various surgical procedures.

The general rule for treating scoliosis is to monitor if the curve is less than 20 degrees. Curves greater than 25 degrees, or those progressing by 10 degrees but under control, may require treatment. Whether to treat scoliosis immediately or simply monitor it is not an easy decision. The option that scoliosis will progress by more than 5 degrees may be lower or higher than 5%, and may be 50-90%, depending on the severity of the curve or other predisposing factors:

- age. The older the child, the less likely the curve will progress. Scoliosis in a child under 10, for example, is more likely to progress than in adolescents. Experts estimate that curves less than 19 degrees will progress in 10% of girls aged 13-15 and 4% in children over 15 years of age. An 18-year-old young man who has a curvature of 30 degrees and is not treated because his growth is likely to have almost stopped has a lower risk of developing scoliosis. However, a 10-year-old girl with the same curvature requires immediate treatment. But in some rare severe cases, the curve can worsen even after the child has received treatment and has stopped growing. Body weight can press on the curve;

- floor. Girls have a higher risk of scoliosis progression than boys;

- curvature location. Thoracic curves, i.e., in the upper part of the spine, are more often progressive than thoracolumbar or lumbar curves (in the middle and lower part of the spine);

- severity of curvature. The higher the degree of curvature, the more likely the progression of scoliosis. Some experts argue that the degree of the curve alone cannot identify patients with moderate to severe scoliosis, who are at the highest risk of complications and therefore need treatment. For example, in predicting the severity of curvature, the flexibility of the back and the degree of asymmetry between the ribs and vertebrae may be more important than the degree of the curve;

- the presence of other diseases. Children with an existing predisposition to scoliosis and lung and heart problems may require immediate, intensive treatment.

Prediction and degree progressions curvature

In children and adolescents. Once a mild curve is found, a more difficult step is needed: predicting whether the curve will progress to a more severe condition. Although 3 out of every 100 adolescents are in serious need of at least observation, progression varies greatly from person to person. Physicians cannot rely on any precise risk factors for curve progression and cannot predict with any degree of certainty which patients need more serious treatment. Some factors can help identify patients at lower or higher risk:

• larger angle of curvature. For example, when the 30-degree bend, but there is a risk of progression of scoliosis by 60%;
• a curvature caused by congenital scoliosis (a problem with the spine at birth), which can progress rapidly
• treatment with growth hormone;
• the curve is less likely to progress in girls who have had scoliosis in the lower back and spine.

Height also matters a lot.

In adults. In rare cases, undiagnosed or undertreated scoliosis in young people can pass into their adult life with curvature, carrying high risks:

• curvature up to 30 degrees almost never progresses;
• progression curves around 40 degrees are questionable;
• curvature of more than 50 degrees is a high risk of progression.

Which is better for scoliosis, corsets or surgery?

The following criteria are used to determine whether a patient should wear a brace and undergo conservative treatment, or undergo surgery:

Corsets and posture correctors are typically used on children with curvature between 25-40 degrees who will still grow significantly;
- surgery is suggested for patients with a curvature of more than 50 degrees in the absence of treatment with posture correctors. In adults, scoliosis rarely progresses above 40 degrees, but surgery may be needed if the patient is in severe pain or if the scoliosis is causing neurological problems.

Braces are usually prescribed to prevent further progression of the curves by at least 25 degrees and no more than 40 degrees. Results vary widely, depending on the length of time the staples are worn, their type, and the severity of the curve. It is difficult to say unequivocally which braces are more effective, here you need to evaluate whether the curvature progresses with use.

In overweight adolescents with idiopathic scoliosis, posture correctors are less effective than in those who are not overweight.

A corset is one type of treatment for scoliosis. They work by applying pressure to the back and ribs to push the spine into a straight position. Corsets are usually worn tightly around the torso. For children in the process of growth, a corset is recommended to slow down the further progression of the curvature of the spine. It is usually worn all the time until bone growth stops.

Surgical treatment of scoliosis

Scoliosis surgery allows you to solve three main problems:

• straighten the spine as safely as possible;
• create a balance of the trunk and pelvic region;
• support the correction in the long term.

These goals are achieved in two stages:

• the vertebrae unite along the curve;
• these fused bones are supported by instruments - steel rods, hooks and other devices attached to the spine.

Many surgeons use a variety of instruments, procedures, and approaches to treat scoliosis. All operations require great skill. In most cases, success depends not so much on the type of operation, but on the skill and experience of the surgeon.

The cause of scoliosis often determines the type of procedure. Also important: the location of the curve (thoracic, lumbothoracic or lumbar), single, double or triple curve and its slope. Parents of sick teenagers or adult patients should not be shy - they should always consult a surgeon about specific procedures.

Idiopathic scoliosis. Surgery is usually recommended for children and adolescents with idiopathic scoliosis:

• all young people whose skeletons have finished growing and whose curvature of the spine is more than 45 degrees;
• growing children whose curve has gone beyond 40 degrees

Neuromuscular scoliosis(myelomeningo and cerebral palsy). The operation is performed with a curvature of up to 40 degrees or more in patients younger than 15 years. However, in this group of patients, surgery is considered to be an increased risk. They also have an increased risk of bleeding.

congenital scoliosis. These children have a higher risk of neurological complications from surgery. However, their chances of success are higher if the operation is performed at a younger age.

adult scoliosis. Due to the increased likelihood of complications, medical professionals are more reluctant to operate on this group of patients. Procedures differ depending on whether the adult has idiopathic scoliosis or scoliosis due to muscle and nerve disorders (such as muscular dystrophy or cerebral palsy). In the latter case, patients also need a special approach to reduce the risk of serious complications.

Spinal fusion - fusion of the vertebrae with scoliosis

Most scoliosis surgeries involve the fusion or fusion of the vertebrae - spinal fusion. The instruments and devices used to support the fusion vary.

During the procedure, the surgeon lifts the flaps that are along the curve, removes the bony growths along the vertebrae, which allows the spine to rotate and bend, places the bone grafts vertically along the exposed surface of each vertebra, taking care that they touch the adjacent vertebrae, folds the vertebrae back into their original position, covering the bone grafts. These grafts will grow into the bones, fusing with the vertebrae. Bone grafts ("autografts") are made from the bones of the patient's thigh, rib, spine, or other bones. However, because the autografts are taken directly from the patient's bones, the operation usually takes longer than usual, and the patient has more pain afterwards.

Researchers are carefully studying the possibility of using allografts (these are organs or tissues transplanted between allogeneic individuals, i.e. obtained from a donor) - they would reduce the pain and duration of the operation. Allografts pose an increased risk of infection from the donor. More modern materials used today are made from biologically manufactured human bone protein instead of bone grafts.

In order to prevent further curvature, the rest of the spine is left flexible. The vertebrae fuse up to 3 months, although sometimes it takes 1-2 years until they are completely fused.

Harrington procedure. Sometimes, for additional support of the spine during fusion, the surgeon uses a steel rod extending from the base to the top of the curve (the surgeon may use more than one rod, depending on the type of curve and whether the patient has an outward curvature of the spine). However, this procedure is used for progressive and severe disease.

After this operation, patients must wear a special cast corset made of plaster and lie in bed for 3-6 months until the fusion is sufficiently complete to stabilize the spine. After 1-2 years, the steel rod will no longer be necessary, but it will almost always remain in place unless infections or other complications occur.

The Harrington procedure is very complex, especially for young people, although the operation can achieve 50% curve correction. The operation in later life does not interfere with normal pregnancy and childbirth. However, after this procedure, some complications may occur:

In about 40% of patients, surgery causes a condition called "flat back syndrome". This syndrome develops due to the need for prolonged bed rest, which excludes the maintenance of normal lordosis (internal curvature of the lower back). Flat back syndrome does not cause pain, however, in later years discs below the fusion of the vertebrae may become damaged, making it difficult for the person to stand upright. And this can cause severe back pain and emotional distress;
- Studies have shown that 5-7 years after surgery, between one-fifth and one-third of patients who undergo the Harrington procedure have low back pain. At the same time, the pains were not so severe as to interfere with normal activities and did not require additional operations;
- In children under 11 years of age, the spine is immature and the Harrington procedure poses a rather high risk for progression of the curvature. This condition occurs when the front of the fused spine continues to grow after the procedure. The spine cannot grow in length, so it bends and scoliosis develops again.

Cottrell-Dubousset procedure. This procedure corrects not only curvature, but also twisting, and does not cause flat back syndrome. This treatment method is based on the use of an implant consisting of rods and fixation hooks. The rods are given the necessary bend and attached to the vertebrae. Patients often return home 5 days after the procedure and can study or work as early as 3 weeks.

Growth technique Rod. This method is used for very young children who have not been helped by wearing posture correctors. Instead of performing a spinal fusion, doctors surgically insert a rod into the patient's back. The patient has a rod extended every 6 months so that the spine can continue to grow.

Vertebral body suturing and anterior spinal tract. Surgeons perform these procedures using anterior approach surgery and without synthesis. Vertebral body stapling is an experimental method that can prevent curve progression in some young patients with curves less than 50 degrees. The method involves suturing the outer curve of the side from the spine forward to the ribcage, helping to stabilize and reduce the progression of the inner curve. The short-term results of these procedures have been favorable.

Complications of surgical procedures with scoliosis

- Postoperative therapy. Patients should restore breathing and normal cough through special exercises shortly after the procedures and continue after the recovery process to normalize lung function. They will also benefit from occupational therapy using stretching and strengthening exercises, NSAIDs (non-steroidal anti-inflammatory drugs such as Aspirin) for pain relief.

- Repeat surgery. Patients may be prescribed corrective procedures, usually for one of the following reasons:

• refusal of the previous procedure;
• progression of curvature around the fusion of the vertebrae;
• degeneration of the intervertebral disc;
• poor posture alignment;
• minimally invasive surgery.

Treatment of scoliosis in adults

Adults who were treated for scoliosis surgically in their youth are at risk for disc degeneration and spinal synthesis insufficiency.

In most adults with pre-existing scoliosis, moderate exercise is not harmful and is essential for maintaining muscle health and preventing disc degeneration. However, people who have only one or two mobile lumbar vertebrae below the area that was fused during surgery should avoid activities or exercises that cause excessive twisting of the spine. This can accelerate spinal degenerations.

- Non-surgical treatment of scoliosis in adults. In most cases of adult scoliosis, if possible, non-surgical care is preferred. This may include teaching the patient specific exercises. Wearing posture correctors is not effective. . Epidural steroid injections are a beneficial alternative to surgery for patients with degenerative lumbar scoliosis.

- Surgical treatment of scoliosis in adults. candidates for surgery. Pain is the most common reason for scoliosis surgery in adults. Surgery may be recommended in the following cases: curvature of more than 50 degrees with constant pain; curvature of more than 60 degrees (operations in this case are almost always recommended); progression of medium to low back curves or low back curve with constant pain.

Most surgeons are reluctant to operate on patients with severe lung dysfunction and heart failure. The operation will not improve lung capacity, it can make things worse, at least temporarily. If there are significant deformities, adults should not expect to achieve a perfectly straight back. There is a high risk of nerve damage if the spine is not already corrected, as it is less flexible in adults than in children. But correction is usually achieved with an acceptable cosmetic effect. Surgeons prefer to work with adults under 50, although surgery may be appropriate in some older people.

- standard procedures. The procedures are as follows, depending on whether the patient has been pretreated or not:

For patients who have not had previous treatment and who have degenerative scoliosis, discectomy procedure (removal of diseased discs), then scoliosis procedure (TRI and synthesis);

For patients previously treated for scoliosis, the only remedy is to remove old appliances and introduce new appliances and bone grafts.

Surgical procedures for treating scoliosis in adults are complex. They are done only after a thorough analysis, when all non-surgical methods have already been exhausted. In adults, the risk of complications is much higher than in children: pneumonia, infections, poor wound healing, constant pain.

- Wedge osteotomy. Recently, wedge osteotomy has been used in the treatment of scoliosis in patients with a mature spine. During this procedure, the surgeon cuts out wedges of bone from the concave side of the curve, then straightens the spine by inserting a temporary nail and closing the corresponding section. The patient should wear the posture correctors recommended by the surgeon and limit activities for about 12 weeks or until the bones have healed. He can return to normal activities only when the surgeon removes the rod, and the spine becomes mobile.

The impact of scoliosis on pregnancy

Women who have been successfully treated for scoliosis have only minor and no additional risks of complications during pregnancy and childbirth. The mother's history of scoliosis does not threaten the child. Pregnancy itself, even if it is multiple, does not increase the risk of curve progression. However, women who have severe scoliosis that limits lung function should take better care of their health.

Forecast scoliosis

The severity of scoliosis depends on the degree of curvature and whether there is a threat to vital organs - in particular, the lungs and heart.

• Mild scoliosis (less than 20 degrees) is not serious and does not require treatment other than monitoring.
• Moderate scoliosis (25-70 degrees). It is not yet clear whether mild scoliosis causes serious health problems later on.
• Severe scoliosis (more than 70 degrees). Severe twisting of the spine that progresses to structural scoliosis can lead to pressure from the ribs on the lungs, restricting breathing and reducing oxygen levels. Distortions can also cause dangerous changes in the heart.
• Very severe scoliosis (more than 100 degrees). The lungs and heart can be damaged. Patients with this severity are susceptible to lung infections and pneumonia. However, this problem is very rare.

Complications of scoliosis

- Influence on the bones. Scoliosis is associated with osteopenia, a condition characterized by bone loss. Many teenage girls who have scoliosis also have osteopenia. Osteopenia, if left untreated, can later develop into osteoporosis. Osteoporosis is a more serious loss of bone density that is common among postmenopausal women. Adolescents with scoliosis are at an increased risk of developing osteoporosis later in life. Regular exercise, vitamin and mineral supplements can reduce and even reverse bone density loss.

- Problems with the spine in patients with scoliosis. After the age of 20, scoliosis occurs in patients who have previously been treated with surgery, and this is usually mild scoliosis. In general, most patients experienced similar conditions as their healthy peers.

Here is a list of some possible causes of back problems in people with a history of scoliosis surgery:

• spinal synthesis diseases - with loss of flexibility and weakness in the muscles of the back due to injuries during surgery;
• disc degeneration and lower back pain, sometimes to the point of rupture;
• height loss - spinal fusion surgery may somewhat inhibit bone growth, but long bones are not affected;
• barrel rotation shift (uneven shoulders and hips);
• problems in adulthood or untreated scoliosis since childhood, causing uneven tension in the back, hips, shoulders, neck and legs.

Many people with untreated scoliosis develop arthritis in their spine. Joints become inflamed, cartilage develops, disc pads become thin, and bone spurs may develop. If the disc wears out or the curvature progresses to the point where the vertebrae begin to press on the nerve endings, then the pain can become very severe and surgery may be required. But even after surgical treatment, patients are at risk of spondylosis if inflammation occurs in the vertebrae.

To date, quite a few different types of scoliosis are known, differing in type, form, causes of appearance, developmental features and, of course, in the degree of curvature of the spine. A detailed classification of the disease allows the doctor to prescribe the most effective treatment, taking into account the individual characteristics of scoliosis in each individual patient.

The main types of scoliosis

• Congenital- characterized by intrauterine disorders in the development of skeletal bones, intervertebral discs and cartilage.
• Acquired- is formed under the influence of adverse factors and environmental influences (injuries of the spinal column, a weak muscular corset of the back, the constant presence of the spine in the wrong position, and other reasons).

congenital scoliosis

The disease is usually detected in children older than 7 years. Among all congenital types of scoliosis, a special group of myelodysplasias is distinguished, which is an abnormal development of the lumbosacral segment of the spinal column. This condition is caused by improper formation of the lower spinal cord.

In a separate group, dysplastic types of scoliosis, also related to congenital forms, are also distinguished. They are characterized by abnormal processes of bone tissue formation in the lumbosacral segment of the spine, which leads to early ossification of this zone. Externally, a child with congenital dysplastic scoliosis looks thin, pale, has narrow shoulders and poorly developed muscles. The back takes on an oval shape, the chest area is sunken, the head leans forward. The child grows undeveloped, has excessive sweating, the limbs are often cool to the touch. In advanced cases, pronounced disorders of the nervous system appear.

Acquired scoliosis

In medical practice, there are many different types of acquired scoliosis, we will consider only the most famous of them.

1. Rachitic. This type of scoliosis is characterized by early development, so it is most often detected in school-age children. Deformation change of the spinal column is at the level of 9-12 thoracic vertebrae.
2. idiopathic. The most common form of scoliosis, which in most cases is an anomaly that develops in the first years of a child's life. Idiopathic scoliosis is defined as any scoliosis of unknown origin. The disease is detected most often at the age of 4-6 years, as well as in the pubertal period of a child's development.
3. Paralytic. The disease is a consequence of the postponed poliomyelitis. This scoliosis is characterized by rapid progression with deformation changes in the chest and the formation of a costal hump. The disease manifests itself as a sharp weakening of the muscular corset, pathological mobility of the spine, in some cases, weakening of the gluteal muscle, which leads to a change in gait.
4. Primary. Usually the disease develops at school age. This is facilitated by wearing a heavy satchel, sitting in an uncomfortable position for a long time and other unfavorable factors that affect the formation of posture. In this case, the curvature of the spinal column can be both lateral and sagittal (lordosis or kyphosis).
5. Static. The disease develops due to injuries of the spine and pelvic bones, tuberculosis of the hip joint, flat feet and other disorders of the musculoskeletal system. The place of localization of static scoliosis is usually the lumbar spine.
6. Ischialgic. It occurs as a result of severe forms of sciatica, resulting in a curvature of the spinal column in the direction opposite to the painful area of ​​the back.

More rare types of scoliosis develop as a result of Little's disease and with pathologically fused vertebrae after a fracture. There are also many other factors provoking the occurrence of this disease.

Forms of scoliosis of the spine

• C - figurative. It is characterized by one arc of curvature.
• . It has two arcs of curvature.
• Z - figurative. It has three arcs of curvature.

According to the location, scoliosis is divided into:

1. cervical
2. cervicothoracic
3. lumbar-thoracic
4. Lumbar (lumbar)
5. Combined (in case of S or Z-shaped curvature)

Scoliosis degrees

• 1 degree. Deformation of the spinal column is almost imperceptible. An accurate diagnosis can be established by taking pictures in several projections. In this case, the angle of lateral deviation, characteristic for the first degree, is no more than 10 degrees.
• 2 degree. Deformation changes become visually noticeable. There is an asymmetric arrangement of the shoulders and shoulder blades, there is a torsion of the vertebrae (rotation around the vertical axis). On the radiograph, the angle of deviation from the norm should not exceed the mark of 25 degrees.
• 3 degree. A pronounced costal hump appears, the motor activity of the spine is greatly reduced. X-ray deformation angle does not exceed 40 degrees. Clinical manifestations of this pathology are characterized by heart and lung failure, shortness of breath with minor exertion, severe sweating and weakness.
• 4 degree. At this stage of the disease, there is a pronounced deformation of the vertebrae, noticeable even in a dressed person. The angle of lateral deviation of the spine for this degree starts at 50 degrees. The chest becomes barrel-shaped, visually the torso looks shorter, and the limbs are elongated. Significant changes are observed in the work of many internal organs, edema of the extremities appears. People with such scoliosis are disabled people who need constant help and care.

Scoliosis classification according to Cobb

The Cobb classification divides the disease into five groups, depending on the nature of their origin.

• 1 group. myopathic scoliosis. They develop due to poorly developed muscles and ligaments of the back. This group also includes rachitic forms of the disease, often affecting muscle and nervous tissue.
• 2 group. Neurogenic scoliosis. This group includes all scoliosis caused by a change in the nervous tissue as a result of sciatica, infectious diseases (for example, poliomyelitis), spastic paralysis, neurofibromatosis, and other causes.
• 3 group. Scoliosis caused by abnormal development of the bone tissue of the ribs and vertebrae. Usually such scoliosis is congenital.
• 4 group. Scoliotic formations appearing as a result of various diseases of the chest.
• 5 group. This group contains all scoliosis, the origin of which has not been studied by medicine. They are called idiopathic.

A disease such as scoliosis, that is, spinal deformity under the influence of congenital or acquired factors, needs to be classified in order to determine medical tactics for elimination or correction. The differentiation of types of the disease according to the signs is dictated by professional necessity.

Types of spinal curvature are professionally motivated generalizations of vertebral deformities resulting from various etiological factors. The need to subdivide typological features is dictated by the presence of certain forms of pathology, the negative factors that can cause them, the degree of damage to the spinal column in relation to the relative norm.

The classification of scoliosis, as in the case of other diseases, became necessary as the pathology spread, caused by hereditary anomalies in the structure or the impact of external negative causes.

Each pathological type of curvature of the spine, which is determined by the history of development, can be conditionally assigned to two main groups, characterized by the acquired or acquired nature of the disease. Scoliosis and its types are distinguished by two main parameters. This is a congenital or acquired disease.

Congenital includes bone pathologies and anomalies in the structure of the back, obtained during fetal development, resulting from traumatic injuries during this period, or transmitted at the genetic level. Acquired, obtained in the process of life, in its etiology has a wide range of negative factors of internal and external influence.

congenital scoliosis

The diseases assigned to the first group are myelodysplasias - a whole group of congenital pathologies that developed during the formation of the lumbosacral region, which are caused by improper formation of the lower spinal cord.

Dysplastic anomalies, which led to a congenital disease, are a prerequisite for early ossification of the sacral segment zone, which gives rise to developmental pathologies, often associated with mental insufficiency and nervous diseases.

Deformation of the spine caused by hereditary or congenital factors often causes disability and various anomalies in the process of further development of the child.

Acquired can be formed both under the influence of past diseases and lesions, and under the influence of a permanent wrong position of the body or heavy physical exertion that falls on the spine due to the type of professional or inactive activity.

There are more variations of curvature of the spine of an acquired nature, and the main ones include:

• rickets (at the level of 8-12 thoracic vertebrae);
• idiopathic (of unknown origin);
• paralytic (the result of polio);
• primary (school);
• static (a consequence of injuries and bone tuberculosis);
• sciatica (damage to nerve endings).

Forms of scoliosis of the spine

The classification of scoliosis is a scientific study carried out on the basis of numerous examples already available, the result of which was the differentiation of degrees, types, factors and causes of spinal deformity.

In medicine, the generalization of existing knowledge into a relatively coherent system of characteristic features greatly facilitates the diagnostic procedure. Certain types of scoliosis of the spine allow you to take therapeutic measures aimed at eliminating the causes, to choose the right tactics for therapeutic measures.

The most common type of curvature with two arcs, which is due to the attempt of the spinal column to stabilize the already existing scoliotic process by bending in the opposite direction.

Forms of spinal deformity are subdivided according to two main typical features. The location of the pathology gives reason to distinguish between the existing types of deformities into cervical, cervicothoracic, lumbar-thoracic, and lumbar. According to the type of curvature of the spinal column, violations are divided into:

• S-shaped scoliosis
• C-shaped
• Z-shaped

S-shaped is characterized by the presence of two arcs of curvature of the spinal column, C-shaped scoliosis - one, Z-shaped - the most severe of all described, it suggests the presence of three arcs of curvature.

In each case, the curvature of the deformed arch (or arches) becomes the basis for determining the degree of deformation of the spinal column, which is the relative value of the progression of the disease itself.

Types of developing scoliosis - degenerative, neuromuscular, functional. Often the determining factor in determining one form or another is the curvature of the vertebral arch.

Scoliosis classification according to Cobb

In attempts to grade scoliosis, the Cobb classification initially became more widespread due to the completeness and validity of the attempt to distinguish between the causes of spinal lesions. The Cobb classification was based on, which later became generally accepted, the division of etiological factors into:

• idiopathic (of unknown origin);
• dysplastic (modifications or disorders of bone tissue);
• osteopathic (malformations of the spine);
• neurogenic (changes in the nervous tissue);
• myopathic (pathological processes in the muscles).

At present, the Cobb classification is mainly used in determining the tactics of surgical intervention or prescribing drug therapy for traumatic lesions, for which an extended injury classification has been developed.

The presence of many pharmacological developments forces the attending physician to draw up an individual intervention tactic for each specific manifestation of the disease. Very often, this disease is the result of the interaction of several groups of causes. This led to the emergence of a fundamentally different classification distinction.

By degree of progression

Such a disease in modern science is divided into 4 groups depending on the degree of progression:

1. The first - the beginning of development, in appearance is indistinguishable from a violation of posture.
2. The second is a pronounced form of back change with a slight angle of inclination.
3. Third - the angle of inclination increases significantly, there is a deformation of the chest, a hump.
4. Fourth - the body is disfigured, the hump is pronounced, the body and pelvis are skewed.

By changing the degree of deformation depending on the loads

This distinction provides for the presence of compensated and uncompensated forms of the disease (balanced and unbalanced), in which an imaginary axial line from the cervical vertebra drawn down passes or does not pass through the intergluteal crease.

Classification according to V.D. Chaklin

Features of the classification according to V.D. Chaklin are based on the degree of scoliotic deformity on the angle of curvature of the back. The angle of curvature in this case is determined by the spondylogram. From 0 to 10 degrees - 1st degree, from 10 to 25 - 2nd degree, from 25 to 50 - 3rd degree, anything more - 4th degree.

The disease can progress suddenly and with considerable rapidity. Even her first degree needs treatment.

The classical classification proposed by L.I. Shulutko assumes the presence of 5 degrees of curvature and has proven herself well in the practice of school doctors and the clinic he runs.

Violation of posture is the most common problem in adults and children. The initial signs of scoliosis can be observed in early childhood. In adulthood, this is exacerbated by the specifics of work and a decrease in physical activity. Scoliosis of the spine in adults is a disease that requires constant monitoring by doctors and preventive and restorative treatment.

Degenerative diseases of the musculoskeletal system develop gradually and over a long period of time. All parts of the spinal column (cervical, thoracic, lumbar) can be damaged. With scoliosis, several parts of the spine are most often involved in the process, which affects the clinical picture of the disease.

Photo: Scoliosis of the spine in adults - congenital causes

It is difficult to identify the primary causes of the development of the disease. Most often it is:

• spinal injury;
• osteochondrosis;
• intervertebral hernia and disc protrusion;
• osteoporosis;
• osteomalacia (softening of the bone tissue);
• complications on the spine after infectious diseases (eg tuberculosis);
• operations on the spinal column;
• unspecified reasons;
• hereditary factor of diseases of the musculoskeletal system;
• poorly treated or undiagnosed childhood scoliosis;
• oncological diseases of the spine or other organs.

Symptoms

Scoliosis of the spine in an adult is always accompanied by pain. The severity of pain depends on individual characteristics. By nature, patients describe burning or constant, aching pain more often in the interscapular region. As the process develops, pain from periodic becomes permanent. This entails a number of changes.

It should be noted that a compensatory person tries to take a comfortable position to reduce the pain syndrome, which is the trigger in violation of the shape of the spine. Additionally, a muscle roller of tension begins to form, which aggravates the pain syndrome.

Of course, scoliosis does not develop within a few days. In most cases, visible changes are noted after many years. This is due to the fact that the musculoskeletal system is quite resistant to various types of loads. Naturally, the process is accelerated if there are additionally other diseases of the musculoskeletal system.

Scoliosis of the spine in adults is not accompanied by fever, and not every person at the slightest pain will go for a consultation with a doctor. Taking various analgesics, the pain syndrome can be stopped, but this does not mean that the process has stopped.

One of the symptoms: decreased sensation in the fingers

This is what is an additional aggravating factor. In addition to the pain syndrome, sensitivity disorders in the fingers, a decrease in muscle strength in the arms and hands can join. It is these changes that the patient begins to notice, and I encourage the patient to consult a doctor.

Briefly, the main symptoms of the disease can be listed as follows:

• backache;
• shoulder asymmetry (one shoulder is higher than the other);
• tension in the back muscles, which leads to stiffness of movements;
• visual changes in the correctness of the spinal column (hump formation);
• changes in the work of internal organs;
• gait disturbance.

There are several degrees of scoliosis in adults

1. Scoliosis 1 degree in adults it is characterized by the fact that the asymmetry of the shoulder girdle is practically not noticeable. The lethargy of posture, the so-called stoop, is striking. The deflection arc angle is not more than ten degrees.
2. Scoliosis 2nd degree in adults it is accompanied by a change in angle from eleven to twenty-five degrees. Visually, there is asymmetry of the shoulders and involvement of the pelvic bones; on palpation, a tense muscle roller is noted in the lumbar region and interscapular region.
3. Scoliosis 3 degrees in adults, the deviation angle is from twenty-six to fifty. Violation of posture with the formation of a bone hump and a secondary change in the chest. There is a distortion of the bones of the pelvis and shoulders.
4. Scoliosis 4 degrees visible to the naked eye in adults. The deformation of the thoracic and lumbar region is so pronounced that it is not difficult to diagnose. Additionally, due to such changes, the functions of internal organs (the gastrointestinal tract, the cardiovascular and broncho-pulmonary systems) begin to be disturbed.

When examining such patients, the doctor always notes the degree of severity of spinal injury, which departments are involved in the process to a greater or lesser extent. This needs to be evaluated, as treatment tactics may vary slightly. Scoliosis is a chronic disease that requires constant monitoring.

If the basic requirements in treatment and prevention are not met, the quality of human life decreases over time. Constant discomfort leads to a violation of the emotional background, and if a visible defect of the disease occurs, it can also lead to the development of depression.

Treatment of patients should be comprehensive with the involvement of psychotherapists to help the patient cope with his disease. Visible changes always aggravate the emotional background and psychotherapists should conduct rehabilitation sessions that will help a person not close and not fall out of society.

Complications

If you do not start treatment of this disease on time, the progression of the process can lead to the following complications:

1. change in the shape of the back;
2. change in the length of the legs and arms;
3. displacement of the pelvic bones;
4. gait disturbance in the form of lameness;
5. development of radicular syndrome at different levels;
6. headaches and dizziness;
7. development of infertility or problems with bearing a fetus.

Diagnosis of the disease

In the initial stages of the disease, it is sometimes quite difficult to determine whether there is a pathological process or not. In addition to an objective examination, the doctor is helped by such types of diagnostic examination as:

• x-ray of the spine;
• Magnetic resonance imaging;
• CT scan.

These studies can be used individually or together. X-rays help determine the degree of scoliosis. It is possible to differentiate scoliosis according to degrees only thanks to this study.

Diagnostic method: MRI

Magnetic resonance imaging helps to determine if there are additional degenerative changes in the spine (hernias, protrusions) and at what level. Thanks to these studies, the most rational and effective treatment tactics are selected.

Of course, if the patient has additional complaints of pain in the region of the heart, constipation, increased urination, and others, a comprehensive examination is carried out with ultrasound, electrocardiogram, and so on.

It is generally accepted that scoliosis of the 1st degree in an adult does not require enhanced treatment, but only rational prevention. It may include a complex of medical and recreational activities, which are selected by a rehabilitation doctor.

With this degree of the disease, the general rhythm of life, as a rule, does not change and there are no strict restrictions. In some European countries, it is believed that changes in the first type can be regarded as a variant of the norm in an adult patient.

Scoliosis of the 2nd degree in an adult leads to some decrease in the quality of life. Constant discomfort requires more frequent and longer treatment and sick leave. Starting from this degree, mandatory treatment of the patient is required in order to prevent a more rapid development of the disease.

Scoliosis of the 3rd degree in an adult patient in some situations requires inpatient treatment. This is due to the fact that this form always involves the internal organs and systems. Visible changes in posture, in the presence of radicular syndromes, may require surgical treatment.

How to treat scoliosis of the spine in adults?

Treatment of scoliosis is aimed at:

• to reduce muscle tension in the back;
• elimination of pain syndrome;
• restoration of the shape of the back;
• restoration of spinal mobility;
• improvement of blood circulation;
• normalization of the work of internal organs.

Correction of scoliosis of the spine in adults can be achieved in two main ways - it is conservative or surgical treatment. The tactics of therapy are chosen exclusively by the doctor. In addition to standard procedures, after the main course of treatment, restorative therapy and disease prevention are mandatory.

Treatment, which is prescribed for this condition, should be comprehensive. It includes:

1. medicinal preparations;
2. surgery;
3. complex rehabilitation therapy (physiotherapy exercises, gymnastics, massage, acupuncture, manual therapy);
4. physiotherapy (electrophoresis, UHF, magnetotherapy, laser therapy);

Medications for the treatment of scoliosis are as follows:

• anti-inflammatory drugs;
• drugs that improve blood circulation;
• vitamin complexes;
• in acute situations, analgesics;
• drugs that reduce muscle tension.

In addition to tablets and injections, creams, ointments and gels are actively prescribed, which are applied to the affected area. By their action, they contribute to skin irritation in a certain area, which improves blood circulation in small vessels, thereby ensuring the delivery of nutrients to damaged segments. This is important, since with an altered shape of the vertebrae, their trophism and nutrition are significantly disturbed.

Rehabilitation therapy is an addition to the main drug treatment. Going through and completing the full course of treatment is very important. The duration of drug therapy depends on the degree of scoliosis, the age of the patient and the presence of additional complications. Against the background of therapy, the patient will notice an improvement in well-being, increased efficiency and mood, and the degenerative process slows down.

Among rehabilitation therapy, emphasis should be placed on physiotherapy exercises. Exercise therapy for scoliosis in adults is carried out under the supervision of an instructor. It helps patients understand which areas need more emphasis. The main task of the exercises is to strengthen the muscles of the back, the upper shoulder girdle, improve the mobility of the spine, and eliminate muscle clamps.

With regular exercise, ventilation of the lungs increases as a result of a decrease in back pain. As a result of exercise therapy, the physiological curves of the spine are gradually restored, and there is a decrease in the load on the intervertebral discs. Exercises should apply to all parts of the spine.

At first, they perform simple and not difficult tasks, as the body begins to adapt to new conditions, and the muscles do their work in sufficient volume, the exercises complicate, and the duration of the exercises increases. All tasks are based on simple actions.

These are tilts of the head forward and backward, gradually adding circular movements of the head. It should be borne in mind that during gymnastics there may be some contraindications for performing certain exercises. After exercises on the cervical region, tasks are gradually added to improve the work of the thoracic and lumbar regions.

Circular movements in the lower back will relax the deep and superficial back muscles. Exercises for scoliosis of the spine can be performed both in a standing position and lying down. Tasks are carried out gradually, at a slow pace, this will allow you to additionally carry out breathing exercises.

Contraindications to physical therapy

1. acute pain syndrome;
2. increased blood pressure and the presence of cardiac pathology in the acute phase;
3. disorders of coordination and diseases of the vestibular apparatus;
4. temperature increase;
5. exacerbation of other chronic pathology;
6. condition after surgery.

Whether it is possible to cure scoliosis in adults once and for all is a rather controversial issue. Since different degrees of this disease were described above, it must be understood that the treatment costs for these conditions are different. Some experts may say that it is quite possible to cure scoliosis of 1-2 degrees, but this will entirely depend on the patient himself. Scoliosis of 3-4 degrees is treated mainly by surgical methods and, of course, in such conditions it is difficult to talk about a complete cure.

The main task of surgical treatment is the restoration of the physiological shape of the spine, reducing the impact on internal organs and systems. Correction of scoliosis in adults by this method is an extreme measure in the absence of the effect of conservative therapy and the progression of the process.

Any operation, especially on the spine, requires a long recovery period. Therefore, patients who are operated on every 3-6 months undergo a course of adjuvant therapy. After the operation, patients are prescribed special bandages and corsets, which are worn constantly or for a certain period of time.

Prevention

• yoga therapy;
• Spa treatment;
• ethnoscience;
• wearing special bandages and corsets;
• lifestyle changes (weight loss, balanced physical activity).

Each person can independently carry out gymnastics for scoliosis, but the set of exercises and the duration of training are determined by the doctor. Treatment of scoliosis in adults at home should be carried out regularly, avoiding gaps. Indeed, in the process of training, the body gets used to new tasks and the muscles adapt to it.

In addition to general strengthening exercises, a massage with scoliosis gives a very good effect. Techniques can be used different (classic, segmental, point, can). In some cases, a combination of different techniques in one session is allowed. The effectiveness of the massage will last longer if the patient sleeps on the right mattress.

A balanced diet is of great importance in this disease. Patients are recommended to eat fruits, vegetables, meat, herbs, fish. You should limit the intake of salt and all possible spices, seasonings, smoked or fried foods, sugar. It is better to drink herbal decoctions and teas, it is advisable to exclude the use of coffee and alcohol.

The use of traditional medicine is aimed at reducing pain. Most often, compresses and mixtures are used, which are applied to the affected area. Do not quit classes and therapy as soon as you feel better. It is not rational to constantly use painkillers that bring temporary relief, and the disease itself is not treated.

If scoliosis of the spine is detected in adults, treatment should begin at the first manifestations of the disease, since in advanced cases it is difficult to correct the situation even with the help of surgery. Scoliosis manifests itself as an abnormal curvature of the spine. Most often, the disease develops in children, less often it is detected in adults. In childhood, the disease is virtually asymptomatic, but scoliosis in adults has its own characteristic symptoms and signs.

Scoliosis of the spine in adults can appear as a result of surgery on the spine, after suffering diseases of an infectious nature, various pathologies in the spinal region, as a result of oncology, etc. Treating scoliosis in adults is quite difficult, so the sooner the disease is diagnosed, the greater the chance of a successful outcome.

Signs of the disease

Curvature of the spine in adults does not pass without a trace. The main symptom is back pain. It can be dull, aching or sharp, very strong, from which it is impossible not to breathe or move. Such symptoms may indicate compression of the nerve endings that are in the region of the cervical spine.

Scoliosis of the spine in adults can be of several types, and depending on the location of the curvature, severe pain will appear. In addition to pain, there are other symptoms or signs that are characteristic of scoliosis in adults. They appear as:

• shoulder asymmetries;
• visible changes in the curvature of the spine;
• disorders of the musculoskeletal system;
• discomfort and stiffness when walking;
• frequent colds;
• feelings of numbness in the upper and lower extremities;
• the appearance of a hump;
• pain in the hands;
• violations of the functionality of internal organs;
• changes in arm length.

Scoliosis in adults leads to displacement of internal organs, displacement of the mediastinum, to curvature of the aorta (leads to the development of hypertension). The inclination of the pelvis changes and the costal arch approaches it, resulting in the descent of the kidney. When the kidney descends, the ureter bends, which leads to a violation of the functionality of the urinary organs and the development of urolithiasis. In particular, a somatic disease develops - that is, there may be a feeling of pain in the region of the heart, stomach, head, but there are no clinical evidence of violations of the functionality of internal organs.

It is not uncommon for a person with scoliosis to try to relieve symptoms with pain medication, leaving the cause of the symptoms to go untreated, the scoliosis to progress, and the person to die slowly. To prevent this from happening, when the first symptoms appear, you should immediately consult a doctor - therapist or traumatologist.

Treatment Methods

Treatment of scoliosis in adults involves the elimination of the causes of the development of the disease, the elimination of blocks that lead to impaired mobility and gait of the patient, the strengthening of bone tissue, the elimination of negative symptoms and the consequences of scoliosis. Mandatory treatment of scoliosis involves improving blood flow in the area of ​​the damaged spine.

When diagnosed with scoliosis, treatment in adults consists of prescribing:

• orthotics (the procedure involves wearing a special corset that will help fix the spine in the desired position);
• medical gymnastics;
• manual therapy;
• physiotherapy;
• medical treatment;
• surgical intervention.

Curvature of the spine in adults can be corrected with a special corset, which can be supportive and corrective. A supporting corset is prescribed most often after spinal surgery, when the curvature of the arch itself is insignificant. Corrective corset correct more serious curvature. The period of wearing it is at least 6 months.

As a conservative treatment for scoliosis and adults, various local preparations are used to help alleviate the unpleasant symptoms of the disease and strengthen the body. In particular, a vitamin complex is prescribed, where vitamins Ca, P, D must be present. They also prescribe means for rubbing into the spinal column, which are available in the form of a talker, cream or gels. Desensitizing drugs are administered intramuscularly. Painkillers are also prescribed to help relieve pain in the spine.

Be sure to prescribe for scoliosis physiotherapy, therapeutic massages. With the help of massage, muscles are toned, posture straightened, and blood circulation improved. You need to entrust your spine to a good specialist. You can not engage in self-massage with scoliosis, since inept movements can lead to even greater disorders and severe pain. As a rule, a referral for a massage can be taken from the attending physician and done free of charge or for a minimal fee directly at the clinic itself.

As physiotherapy, visiting the pool, heat therapy, magnetotherapy, mud treatment, electrical muscle stimulation are recommended. A visit to the pool will help to develop motor activity, improve posture, help to establish respiratory function, which also suffers from scoliosis.

In the form of therapeutic exercises, special exercises are prescribed to help form the muscular corset and strengthen it. The most suitable are yoga exercises - asanas, which are allowed to be performed at any age, including mature ones. If you have the skills and opportunity, you can go skiing.

All these methods of treatment are indicated in the first and second stages of scoliosis, then only surgical intervention is prescribed.

Operational actions

This type of treatment for scoliosis in adults is prescribed most often, since rarely in an adult the disease can be treated with local drugs and procedures.

In some cases, surgery is the only way to relieve severe pain and improve the functioning of internal organs that suffer greatly in scoliosis.

Surgery for scoliosis in adults is prescribed for:

• constant, incessant pain;
• complete ineffectiveness of conservative therapy;
• neuralgia;
• deformities of the highest degree;
• cosmetic defect (young people under 30 often try to eliminate the consequences of scoliosis in the form of a hump on the back or curvature of the back with the help of surgery);
• cardiopulmonary insufficiency.

During the operation, a special prosthesis is attached to the vertebral region, which will simultaneously support the spine and prevent the progression of the disease. For children, special metal implants have been created, which are a type of movable plates on a rod. For adults, such structures are made immobile, since their spine will no longer grow and develop.

The operation to correct the spine is fraught with various complications, and its cost is not small. That is why it is so important not to start the course of the disease, but to find time and consult a doctor at the first unpleasant symptoms.

Special exercises at home

If there is no indication for urgent surgery, you can try to align and strengthen the spine at home. In particular, great attention should be paid to exercises that will help correct posture, eliminate excess weight (it can be the cause of scoliosis). The main thing is not to make sudden movements during physiotherapy exercises, so as not to injure the spine. As exercises, hanging on the horizontal bar, “bicycle”, squats, abdominal exercises, etc. are suitable.

You can do back exercises. To do this, lie on your stomach and raise your head and legs at the same time, without leaning on your hands. In general, each exercise should be performed at least 15 times, 2-3 sets each. If the physical form is in a deplorable state, then each element must be done as far as possible, but each time the movements must be increased. It is undesirable for scoliosis to engage in step aerobics, jumping, running, etc.

Folk recipes

You can eliminate painful symptoms in the back area with the help of compresses. An alcohol tincture of chestnut flowers has proven itself well. To prepare it, you need to take a container of 1 liter. fill 1/3 with flowers, pour 350 g of vodka or diluted alcohol and leave to infuse for 2 weeks. Periodically, the container must be taken out and shaken. In order not to burn the skin with alcohol, you can dilute the tincture with a small amount of water before use. Apply the product to the back area should be slightly heated, rubbing it with your hands or a cloth.

You can take baths with the addition of sea salt. After that, the back should be lubricated with a special ointment prescribed by the doctor. For rubbing the back, a concentrated solution of sea salt is prepared. If possible, it is better to take a bath with salt water, if not, a saline solution will do.

Raw potatoes and hot peppers or horseradish root must be chopped in a blender (you can use a meat grinder), then put a piece of gauze on the vertebral region and lay out the gruel of vegetables. From above, the compress must be well wrapped so that it thoroughly warms the back. A pepper patch has a similar effect, but sometimes its effect is very weak, so it is better to prepare a vegetable warming compress.

An alcohol compress for scoliosis can be prepared from dandelion flowers. To do this, you need to take a 500 ml jar, fill almost half with flowers and pour vodka. You need to insist the mixture for about a week in a dark, cool place, and then apply it as a back rub.

You can quickly relieve the pain of scoliosis with a mixture of aloe, honey and vodka. These components should be mixed and applied to the area of ​​pain before going to bed. From above, you can cover such a compress with a cabbage leaf and wrap it with a woolen scarf.

Pine branches also help in the treatment of scoliosis in adults. They need to be poured with a large amount of water (10-15 l) and put on fire, where after boiling you need to reduce the heat and cook for about 7 minutes. After that, a decoction of pine branches is infused for 3 hours and added to the bath for bathing.

While rubbing the back, the heart area should be avoided. Therapeutic baths, the temperature of which should be high, are contraindicated in the presence of varicose veins, cardiovascular diseases, during pregnancy. It is necessary to combine traditional medicine with traditional medicine. So the result will be achieved much faster.

If scoliosis is suspected, one should not self-medicate, since this disease is very serious and requires an integrated approach. Scoliosis in adults is not treated only with medication or with the help of physiotherapy. Moreover, it cannot be cured exclusively by folk remedies. The treatment regimen selected by the doctor is the surest way to recovery.

Scoliosis of the spine on x-ray

Sufficiently serious disease is scoliosis of the spine in adults: the treatment of this disease in adulthood will be difficult and lengthy. It will likely require surgery.

But to eliminate the curvature of the spinal column, as far as possible, it is necessary. Otherwise, pathologies of internal organs may develop, which will lead to the occurrence of dangerous diseases.

What is scoliosis?

Scoliosis is a curvature of the spinal column, which is initially lateral, but gradually spreads to other planes. In the most severe form of scoliosis, the patient has twisting of the spine around its center line.

Deformation of the spine due to the development of scoliosis causes a change in the natural arrangement of the ribs and bones of the chest, as well as the movement of nearby organs necessary for the normal functioning of the whole organism. First of all, the lungs and heart suffer. Scoliosis of the 2nd degree of the thoracic spine in most cases causes respiratory failure and heart failure.

When the bones are displaced, the chest or dorsal hump begins to grow, which disfigures the appearance of the patient and causes him much inconvenience and suffering. In this case, kyphoscoliosis of the thoracic spine may develop.

Kyphoscoliosis of the thoracic spine on x-ray

All physical ailments caused by scoliotic curvature of the spine invariably affect the state of the central nervous system. As a result, patients with scoliosis often suffer from neurotic disorders and depression.

The main types of scoliosis

In adults, acquired scoliosis is observed. After all, congenital scoliosis is usually cured in childhood. The form of scoliosis depends on the number of bends (arcs) in the curvature of the spinal column. In this case, a distinction is usually made between:

1. C-shaped scoliosis (1 arc of curvature);
2. S-shaped scoliosis (2 arcs of curvature);
3. Z-shaped scoliosis (3 arcs of curvature).

Varieties of scoliosis

The localization of the pathological bend determines the following types of scoliosis:

• scoliosis of the cervical spine;
• thoracic scoliosis;
• scoliosis of the lumbar spine.

Thoracic scoliosis

The most common type of scoliosis is scoliosis of the thoracic spine. The curvature occurs in the thoracic segment of the spinal column at the level of the 8th and/or 9th vertebra. Depending on the nature and direction of the curvature, left-sided and right-sided scoliosis of the thoracic spine is distinguished.

The initial stage of the disease - scoliosis of the 1st degree of the thoracic spine causes a slight curvature of the spinal column in the chest area. Timely treatment and regular sports activities can almost completely eliminate this pathology.

Over time, in the absence of proper treatment, scoliosis of the 2nd degree of the thoracic spine may begin. In this case, the angle of curvature increases by 2-3 times, which becomes noticeable to others. This causes significant nervous disorders in the patient, which can gradually turn into a serious illness.

Further, the following degrees of scoliosis of the spine in the thoracic region develop, in which the disease becomes more severe. In particular, with 3 degrees of thoracic scoliosis, deformation of the sternum and ribs and the development of the costal hump are observed. At 4 degrees of scoliosis, almost the entire body is deformed, up to the pelvic bones. The patient begins kyphoscoliosis of the thoracic spine. This leads to difficulty in normal breathing and disruption of the functioning of the cardiovascular system.

Degrees of scoliosis of the spine

The main causes of scoliosis

Scoliosis of the spine in adult patients most often develops under the influence of factors such as:

• genetic predisposition;
• lordosis, poliomyelitis, rickets, osteochondrosis;
• intervertebral hernia;
• dysfunction of bone and connective tissue;
• tuberculosis and some other infectious diseases;
• destruction of the bone tissue of individual vertebrae - osteoporosis;
• pathology of the musculoskeletal system;
• malignant tumors and metastases in different parts of the spine;
• degenerative consequences of surgery;
• weakness of the spinal muscles and vertebral ligaments;
• softening of the vertebral bone tissue - osteomalacia;
• sedentary lifestyle;
• spinal injury;
• excessive load on the spinal column;
• violation of posture;
• various idiopathic factors.

Scoliosis symptoms

The first manifestation of scoliosis in adults with a fully formed musculoskeletal system is pain. Back pain can begin due to pinching of the spinal nerve endings with incorrectly located vertebrae.

Among other symptoms and signs of scoliosis of the spine, factors such as:

• asymmetrical shoulder girdle;
• a clear deviation of the spinal column from the vertical line (checked with a plumb line);
• painful and difficult movements;
• circulatory disorders of the extremities, their numbness;
• obvious violations of posture;
• the appearance of a hump and a depression on the opposite side;
• problems with the respiratory and cardiovascular system;
• frequent colds;
• general weakness.

Diagnostic measures

The curvature of the spine can be noticeable during a personal examination of the patient by an orthopedic doctor. To determine the severity of the disease, an X-ray examination of the spine is invariably performed.

X-ray of the spine

The resulting images allow you to set the angle of curvature of the spinal column. Due to this, the severity of the disease is determined in each case. Additional information about the clinical picture of the disease is obtained through computed tomography and magnetic resonance imaging of the spine.

Scoliosis treatment

When spinal scoliosis is observed in adult patients, treatment involves conservative therapy or, in especially severe cases, surgical intervention. In general, treatment is carried out with the aim of:

• normalize the position of the spine;
• restore the musculoskeletal system;
• relieve the patient from back pain;
• intensify blood circulation in the spinal region;
• strengthen muscles.

Conservative therapy for adult scoliosis is carried out according to a complex scheme, which is adjusted by a specialist for each patient individually. Basically, anti-scoliosis therapy includes the following treatments:

1. Drug therapy to relieve pain and restore the functions of the respiratory and cardiovascular systems.
2. Therapeutic exercise to strengthen the muscles of the back.
3. Massage that strengthens the spinal muscles and improves blood circulation in the paravertebral tissues;
4. Various methods of orthopedic traction.
5. Wearing a special corset to relieve the load, fix the spine in the correct position and stop pathological processes.
6. Therapeutic swimming to reduce the load on the spinal muscles and restore the normal functioning of the respiratory system.
7. Classes in some sports according to special techniques for correcting posture and strengthening back muscles.
8. A cycle of acupuncture treatment to relieve muscle tension, relieve pain and normalize the patient's state of mind.
9. Physiotherapeutic procedures and mud therapy.
10. Yoga classes under the guidance of a specialist.

Yoga for scoliosis treatment

All of the above methods of treatment are effective in the early stages of scoliosis (1st and 2nd degree of severity). With careful implementation of all procedures and constant sports activities, the curvature can be eliminated almost completely. The intensity of scoliosis symptoms decreases significantly.

Surgical treatment of scoliosis

Surgical intervention is performed in the treatment of scoliosis of the 2nd, 3rd or 4th degree. The main indicator for the use of surgical methods is the low efficiency of conservative therapy.

There are several ways to surgically treat curvature of the spine in adulthood. Among them are methods such as:

1. Implantation of special metal structures for posture correction and fixation of the spinal column in the correct position.
2. Restoration of damaged vertebrae and vertebral discs.
3. Fixation of the spine in a certain position in an operative way.
4. Correction of violations of the structure of the chest by the surgical method.
5. Surgical treatment of the ligamentous apparatus of the spine and spinal muscular system.

Fixation of the spine is performed using a special metal rod - a distractor. The mechanism, located at the top of the rod, moves the hooks attached to the various elements of the spinal column. The distractor is placed on the concave side of the scoliosis arch or on both sides of the spine. To increase the effectiveness of metal-constructive surgical interventions, they are carried out in conjunction with the correction of deformed vertebrae and discs.

Spinal distractor on x-ray

The following operations are performed on the vertebrae and intervertebral discs:

• wedge resection;
• enucleation.

Wedge resection is a dissection and fragmentary removal of damaged vertebral tissues. Using this method, you can significantly slow down the curvature of the spinal column. Implantation of metal structures after wedge resection allows almost complete straightening of the spine.

This operation is performed, mainly with scoliosis in a stable form. An increase in the mobility of individual elements of the spine makes it possible to correct and fix the required position of the spinal column.

Enucleation is performed to eliminate the nucleus pulposus. This is currently done by open papainization. In this case, papain is injected into the tissue of the nucleus pulposus to dissolve it.

All metal-constructive and other operations for scoliosis are performed in conjunction with posterior fusion. Fixation of individual components of the spinal column is carried out by immobilization or artificial fusion of adjacent segments.

Mode correction for scoliosis

In the early stages of the development of scoliosis, when the angle of curvature is still small, you can try to cope with the disease without the use of serious medical means. In this case, the patient should regularly engage in physical exercises and sports. It is better to draw up a program for this kind of exercise together with an exercise therapy specialist, based on the recommendations of an orthopedist.

As a rule, patients with an initial form of scoliosis are shown:

• daily morning exercises;
• therapeutic swimming;
• skiing;
• sports walking.

Additionally, it is necessary to carry out hardening procedures for general strengthening of the body. The diet should be adjusted in conjunction with a nutritionist. This will not only normalize the weight of the patient, but also provide the body with nutrients and vitamins in the required amount.