Scoliosis, according to its causes, is divided into structural – with a change in the structure of the vertebrae and surrounding tissues, and non-structural – acquired, most often compensatory.
Structural types of scoliosis can cause congenital abnormalities in the structure of the chest or connective tissue pathology, in which the innervation of certain parts of the spinal column changes, osteomyelitis, osteoporosis, tuberculosis, injuries, and spine tumors might occur.
Non-structural variants of scoliotic changes are most often provoked by injuries of the lower extremities and pelvis, as well as their incorrect formation during intrauterine development of the fetus. Less commonly, severe inflammation of muscle tissue, burns, and scars can become the cause.
Scoliosis is divided into 4 degrees depending on the angle of deviation of the spine from its axis. The curvature of the spine of the 4th degree is characterized by an angle of more than 50 degrees and is treated only by scoliosis surgery.
The Symptoms of Scoliosis
Severe deformity, characteristic of the last advanced stage of scoliosis, leads to a change in position and compression of the internal organs. Such a patient is prone to frequent colds. Due to impaired lung excursion, persistent shortness of breath occurs.
Compression of the nerve endings leads to sensory disturbances and discomfort in the arms and legs. Prolonged standing in an upright position causes severe back pain.
Violation of blood flow in the internal organs with a disease such as scoliosis can cause the development of various pathologies. These are chronic inflammation of the small pelvis's organs, ulcerative changes in the intestines and stomach, and heart disease. Scoliotic deformity of the spine can cause chronic pain in the spine, hypertension, angina pectoris, and arrhythmia, which are difficult to treat with medication.
The Diagnostics of Scoliosis
X-rays are used to diagnose the disease. Pictures taken in several projections give a clear understanding of the localization of the pathological process, allow you to determine the curvature's angle, identify the organs' condition, and the degree of degenerative changes in the vertebrae.
Treatment and Prevention of Scoliosis
Prevention of scoliosis is possible in children under 11 years of age.
The treatment of scoliosis of the 4th, the most severe degree, is possible only with a complex surgical intervention.
Conservative Treatment
- Exercise therapy. For minor scoliosis, exercise maintains trunk muscle strength and helps reduce the risk of deformity progression. They are necessary to maintain adequate functioning of the cardiovascular system and lungs;
- Exercise therapy, according to Schroth. With deformations from 20 degrees, it is advisable to engage in special exercises aimed at strengthening the necessary muscle groups and preventing the progression of deformation;
- Chenot corset. With spinal deformities of 25-40 degrees, according to Cobb, a Chenot-type corset is prescribed in patients with growth potential. The purpose of this method is that the corset should prevent the progression of the deformity. But it should be noted that with the help of a corset, it is impossible to align the spine. It is considered successful if, the angle of deformation has not increased during the wearing of the corset.
Surgical Treatment
If the spinal deformity exceeds 40 degrees, Cobb, it is potentially dangerous for the function of the internal organs and requires surgical intervention. For this purpose, systems of implants are used, which are installed on the spine and maximally align its deformation. The disadvantage of this method is the complete loss of movement on the stabilized segment.
The VBT/ASC dynamic fixation method can be used if the spinal deformity is mobile. For this purpose, systems of implants installed on the lateral surface of the spine are used. They are connected to each other with a strong rope that allows movement in a fixed segment.
