Scoliosis - colloquially referred to as lateral curvature of the spine - is the most common posture defect in children. It is most often caused by the lack of movement and incorrect posture while sitting. Scoliosis should not be taken lightly because it can lead to serious complications, including circulatory failure. What are the causes and symptoms of scoliosis? What is its treatment? When is surgery necessary?

Scoliosisis colloquially incorrectly referred to aslateral curvature of the spine(right or left). In factscoliosis is a three-plane curvature- in the plane:

  • frontal (lateral curvature of the spine)
  • sagittal (also called ordoscoliosis or kyphoscoliosis)
  • cross

Instead of the natural, slightly arched form,the spine takes the form of the letter S . Scoliosis most commonly affects the thoracic spine (upper back) or develops between the thoracic and lumbar spine (middle back). It rarely only occurs in the lumbar region.

Scoliosis is more often diagnosed in children than in adults. Lateral curvature of the spine may reveal itself at different stages of their development. Depending on the age of the child, scoliosis can be distinguished:

  • early childhood (up to 3 years of age);
  • children (between 3 and 10 years old);
  • youthful (acquired in adolescence);

Scoliosis often intensifies during adolescence, i.e. during intensive growth. Then the muscles do not keep up with the development of the skeleton and do not provide sufficient support for the spine.

Scoliosis - symptoms

Excessive curvature of the spine in one of its sections contributes to the imbalance of the torso and shifts the body's center of gravity. Then:

  • blades are sticking out
  • there is a hump on one side of the back (the so-called rib hump) - it is the result of ribs being pushed out by the vertebrae
  • shoulders and hips are unequal
  • waistline on one side is much clearer than on the other side
  • one leg is shorter and the other leg is longer (in advanced scoliosis)

Scoliosis, if advanced, can have dangerous complications.It may limit the patient's physical capacity, and also cause degeneration and neurological disorders.

May also lead to a deformation of the chest. Then there may be pressure on the internal organs, including the lungs and heart, and further to circulatory failure and respiratory failure.

Scoliosis - causes and risk factors

Scoliosis may becongenital defect of the spine(including sphenoid vertebra, rib adhesions, Sprengel syndrome). It accounts for about 2/3 of all spine congenital malformations and is often associated with other malformations, such as congenital malformations of the genitourinary system or congenital heart disease.

Acquired scoliosis may be caused by:

  • limb length difference
  • herniated intervertebral disc
  • bone tumors

Lateral curvature of the spine can also occur in patients with muscular dystrophy or cerebral palsy. Then it is the result ofinsufficient muscle developmentdue to neurological changes.

Scoliosis may also appear after pleural diseases and surgeries on the chest performed during the growing period (the so-calledthoracogenic scoliosis ).

However, children are most often diagnosed withidiopathic scoliosis(approx. 85% of cases), the causes of which are unknown. Its development is favored by the lack of movement and incorrect posture while sitting.

In turn, adult scoliosis may appear as a result of the degeneration of the intervertebral joints.Degenerative scoliosisin adults most often results from the deteriorating condition of the spine, usually after the age of 40. It is especially dangerous when it coexists with osteoporosis, as it leads to a complete weakening of the spine.

Scoliosis - diagnosis

Scoliosis in a child can be diagnosed by yourself. Just ask your child to take off their T-shirt, stand up straight and bend forward, touching their fingers to the floor. The child's back should be equally arched on both sides of the spine.

As your baby straightens up, pay attention to her shoulders. If they are not at the same height and the shoulder blade is sticking out, the hip is extended and the waist is more indented on one side, see your doctor as soon as possible. He's also doing a physical exam.

However, the final diagnosis is usually made on the basis of an X-ray of the spine ( although other imaging techniques, such as computed tomography or magnetic resonance imaging, are also possible).

Scoliosis (lateral curvature of the spine) - treatment

Waytreatment of scoliosis depends on the patient's age and the severity of the posture defect.

When scoliosis is detected early (i.e. in people with slight curvature), corrective gymnastics is recommended (exercises in the swimming pool are especially recommended). In some cases, orthopedic corsets are used, which, by pressing on the spine, force its proper positioning, and thus prevent its further deformation. They are worn for several hours a day or only at night.

The doctor may also order you to wear corrective plaster, braces or extracts. In the case of curvatures caused by, for example, shortening of one limb, orthopedic insoles are required.

In patients with severe curvature (when the angle of curvature is>60 degrees), surgical treatment is necessary, with the implantation of metal braces and implants. The procedure is most often performed in adolescents aged 13-15, sometimes also in younger children. Unfortunately, the operation does not restore the spine to full fitness.

A child with a lateral curvature of the spine should sleep on a hard mattress, and the sleeping pillow should be small. The child should sit on a chair with a contoured backrest (bulging in the lumbar region), adjustable in height and elbow supports, and at a desk with a square or rectangular top. Both the height of the chair and the desk must be adapted to the child's height. When the child is sitting at the desk, the feet should be on the floor and the forearms on the table.

Horse riding is not recommended in case of scoliosis. The shocks generated when hitting the buttocks against the saddle may contribute to the aggravation of the curvature.

According to an expertMilena Kowalczyk, physiotherapist and motor preparation trainer from the Carolina Medical Center

Scoliosis is a lateral curve of the spine accompanied by rotation of the vertebrae. If ignored, it may result in serious complications, not only visual, but also results in degenerative changes in the spine, pain and limited mobility. Secondly, it may contribute to changes in the respiratory and circulatory systems.

The angle of the spine is measured on the Cobb scale. We deal with the scoliotic attitude when the Cobb angle is exceeded above 10 degrees. Scoliosis changes with growth and age and is a dynamic process. It can worsen even throughout life, but the greatest therapeutic achievements can be achieved until the age of 18-20, before reaching bone maturity.

Characteristic for scoliosis is, among others: reduction of physiological curvature in the thoracic spine, vertebral rotation, humprib cage, asymmetry of shoulder blades and waist triangles, twisted / oblique position of the pelvis.

The most important in a person with a scoliotic posture, whose Cobb angle is up to 25 degrees, will be, among others: assuming hypercorrective positions, stretching the myofascial and muscle groups that are excessively tense, performing asymmetric strengthening exercises, as well as learning assuming the correct position.

In the case of curvatures between 20 and 25 degrees, according to Cobb, it is recommended to wear an orthopedic corset. When the Cobb angle is greater than 40-45 degrees, surgery may be required.

In all cases of scoliosis, symmetrical extension exercises aimed at strengthening the back muscles, such as airplanes, scissors, frogs, torsions, are strictly forbidden. Hangs and exercises in the aquatic environment are not recommended.

If scoliosis is suspected, the best solution will be to visit a doctor, take an X-ray, and if scoliosis is confirmed - contact a physiotherapist who will individually select the appropriate set of exercises and indicate the right course of action in everyday life.

Category:

Spine, bones, joints