Kyphoscoliosis

Based on the causes of kyphoscoliosis, there are:

Congenital kyphoscoliosis

Congenital kyphoscoliosis is a consequence of intrauterine developmental disorders of individual vertebrae or ribs.

Hereditary kyphoscoliosis

Hereditary kyphoscoliosis manifests itself in a similar form in several generations and is transmitted by a dominant type. Associated with genetic diseases such as Scheuermann-Mau disease.

Acquired kyphoscoliosis

The reasons for the development of acquired kyphoscoliosis can be incorrect posture , uneven physical exertion on different parts of the body, psychological stress, the consequences of injuries and operations on the spine, some diseases of the muscular system and musculoskeletal system, for example, osteochondrosis , tumor formations, rickets , poliomyelitis, tick-borne encephalitis Cerebral palsy .

Idiopathic Kyphoscoliosis

Idiopathic kyphoscoliosis is called in cases where the true cause of kyphoscoliotic curvature cannot be established. Most often, this type of pathology develops in adolescents aged 11-15 years in a period of enhanced growth. In boys, this type of kyphoscoliosis occurs four times more often than in girls.

Four degrees of kyphoscoliosis are distinguished depending on the severity of deformation changes:

• Kyphoscoliosis of the 1st degree - is a curvature with minimal lateral displacement and twisting of the vertebrae. The angle of curvature of the spine in the anteroposterior direction is 45-55 °.
• Kyphoscoliosis of the 2nd degree - is characterized by a more pronounced lateral deviation of the spine and a more noticeable twisting. The angle of curvature of the spine in the anteroposterior direction is 55-65 °.
• Kyphoscoliosis of the 3rd degree - represents the beginning of irreversible deformation processes. For this degree, visible deformation of the chest and the formation of a rib hump are characteristic. The angle of curvature of the spine in the anteroposterior direction is 65-75 °.
• Kyphoscoliosis of the 4th degree - is characterized by severe deformation of the spinal column, chest and pelvis. The curvature is accompanied by the formation of the anterior and posterior humps. The angle of curvature of the spine in the anteroposterior direction is more than 75 °.

Depending on the direction of lateral displacement of the spine, left-sided and right-sided kyphoscoliosis are distinguished.

The first signs of congenital kyphoscoliosis become noticeable when a child reaches 6-12 months, that is, the age when he begins to stand or walk. At this time, in a vertical position of the body, the child has a barely noticeable hump, which disappears when lying down. Over time, curvature becomes persistent. But in the early stages of development, congenital kyphoscoliosis responds well to treatment. In adolescence, the development of kyphoscoliosis is indicated by a change in posture, increased stoop, back and neck pain, dizziness, and fatigue. Due to a change in the shape of the chest, shortness of breath during exercise is possible. Later stages of kyphoscoliosis have a negative effect on the state of the whole organism. First of all, secondary deformation of the chest leads to impaired function of the organs located in it. Due to the limited mobility of the chest, the load on the respiratory muscles increases, the extensibility of the pulmonary parenchyma decreases, and the volume of the lungs decreases. Due to inadequate ventilation of the lungs, gas exchange suffers: in the blood, the concentration of carbon dioxide increases and the concentration of oxygen decreases. As a result, pulmonary hypertension and damage to the cardiac system are likely to develop, including heart failure and pulmonary heart disease. Pathological curvature of the spinal column leads to constant overload of all its structures and paravertebral muscles. In this regard, with kyphoscoliosis, early development of osteochondrosis, the formation of protrusions and hernias of the intervertebral discs, and, as a result, the appearance of neurological symptoms, are possible. In severe cases, kyphoscoliosis leads to sexual dysfunction, impaired digestive system functioning, and urinary and fecal incontinence.

If there is a suspicion of kyphoscoliotic curvature of the spine, an orthopedic examination is necessary. The diagnosis of kyphoscoliosis is made on the basis of external signs and data of instrumental research methods. An external examination reveals increased stoop (in the late stages of the disease - a hump ), narrowing of the chest and weakness of the abdominal muscles, various height of the shoulders, shoulder blades, pelvic asymmetry, visible deviation of the spine from the midline when leaning forward and widening of the intercostal spaces on the opposite lateral curvature side. By palpation of the back, neck and limbs, skin sensitivity, tendon reflexes and symmetry of muscle strength are assessed. If neurological disorders are identified, a neurologist consultation is required. Of the instrumental methods of examination in cases of suspected kyphoscoliosis, the spine radiography is primarily performed to determine the angle of deformation. Along with the two main projections, pictures can be taken in special positions (lying, standing, and stretching the spine). To clarify the diagnosis, methods of layer-by-layer examination of the spine can be prescribed: magnetic resonance imaging and computed tomography . In the presence of symptoms of malfunctioning of internal organs, additional diagnostics and consultation of specialized specialists may be required: cardiologist, pulmonologist, gastroenterologist, urologist.

The initial degrees of kyphoscoliosis successfully respond to conservative therapy . More pronounced curvature usually requires surgical treatment.

Conservative Therapy

• Physiotherapy

Exercise is the main method of prevention and correction of kyphoscoliosis. A set of special exercises for the formation and strengthening of the muscle corset, as well as relaxation and stretching of individual muscle groups individually, is prescribed by the doctor. Since the effectiveness of physiotherapy exercises depends on the correctness of the exercises, it is advisable to conduct classes under the supervision of an exercise instructor. Self-medication and excessive loads, including jumping and weight lifting, are contraindicated in case of kyphoscoliosis and can lead to a significant worsening of the condition.

• Orthosis (corseting)

Mechanical correction of the spine with the help of individually selected corrective orthopedic corsets, declinators and belts to develop correct posture and fix the shape of the spine is effective in the early stage of kyphoscoliosis.

• Physiotherapy

Physiotherapeutic treatment is used to relieve pain, improve blood and lymph circulation, eliminate muscle dystrophy.

• Acupuncture

Proper exposure to acupuncture points helps to get rid of pain, normalize blood circulation in the spine, and eliminate stagnant phenomena. Manual therapy Manual techniques help to improve posture and gait, partially or completely eliminate the deformations of the vertebrae, intervertebral discs, joints and adjacent tissues.

• Kinesitherapy

Unique exercises in special settings help strengthen corset muscles and restore posture.

• Massotherapy

Massage is prescribed for patients with kyphoscoliosis in order to improve blood circulation, increase muscle plasticity and activate metabolic processes in muscle tissue. It is used as a complement to the main course of treatment.

• Drug treatment

Anti-inflammatory and analgesics are prescribed to relieve pain.

Treatment by the method of Gitt V.D. It includes a set of physical exercises to change the muscular skeleton and restore cartilage.

Surgical Treatment

The indications for surgical treatment of kyphoscoliosis are severe cases of spinal deformity, accompanied by severe pain, progressive neurological disorders, impaired function of the chest or pelvic organs. Surgical correction for kyphoscoliosis involves the installation of special metal structures: hooks, screws and rods, with the help of which the spinal column is aligned and localized. In the postoperative period, the patient is shown wearing a plaster corset for several months. Modern designs do not require the wearing of a plaster corset.

Favorable prognosis depends on the degree of kyphoscoliosis and the rate of disease progression. In most cases, with kyphoscoliosis of 1 and 2 degrees, it is possible to completely eliminate the curvature of the spinal column. However, it should be borne in mind that this is possible only until the end of the period of active growth of a person, that is, up to 13-15 years, and therefore the timeliness of all measures taken both in terms of diagnosing kyphoscoliosis and in terms of its treatment is very important. With kyphoscoliosis 3 and 4 degrees of prognosis are less favorable. Full rectification of the spine in such cases is almost impossible. However, adequate treatment can stop the progression of deformity, and in some cases, partial correction can be carried out.

• Scoliosis
• Kyphosis
• Lordosis