Scoliosis is called lateral curvature of the spinal column, which is associated with changes in the position and shape of the vertebrae. One bend (C-shaped scoliosis), two oppositely directed curvatures (S-shaped scoliosis) or three (triple scoliosis) are observed. Each type of scoliosis, depending on the direction of the curvature bulge, has a more detailed designation (for example, left-sided C-shaped scoliosis). With several curvature of the spine, the most significant is considered primary, less pronounced – secondary. The sizes of scoliosis are established by measurements on x-rays using an angle meter and using auxiliary lines; values obtained are expressed in degrees. Etiology. Scoliosis can be congenital, then there are abnormalities in the development of one or more vertebrae. Scoliosis in infants due to improper position of the fetus in the uterus should be distinguished from true malformations. True scoliosis can develop on their background or due to weakness of the muscles of the trunk. Improper posture and lateral curvature of the spine may be due to the unequal length of the lower extremities (static scoliosis), and lateral curvature due to pain (pain scoliosis), for example, with sciatica . Paralytic scoliosis is observed with paresis of the muscles of the trunk, and children’s spinal paralysis was previously considered the dominant cause of their development. In rare cases, true scoliosis is observed due to a prolonged violation of posture due to labor characteristics (professional scoliosis). Scoliosis can also occur due to vertebral fractures (traumatic scoliosis). A large group consists of the so-called genuinous, or idiopathic, scoliosis, and it is not yet possible to establish the cause of their occurrence. There is probably a whole series of various factors acting complexly in certain biological phases of skeletal development.
– high standing of the shoulder on the convex side of the curvature in the thoracic spine
– flattening in the pelvic triangle on the convex side and its deepening on the opposite side at the level of maximum curvature of the lumbar spine
– protrusion of the chest in the dorsal direction on the convex side (dorsal costal hump ) and its diagonal retraction on the ventral side
– bulging of the lumbar muscles on the convex side (lumbar “torsion” roller).
The dorsal costal hump and torsion are especially clearly visible when the body is tilted forward. The described deformations arise due to changes in the position and shape of the vertebrae. The vertebral bodies on the concave side are flatter than on the convex side. These changes are detected radiologically, and at the top of the curvature they are most pronounced.
In addition, compensatory pelvic distortion is possible, due to the fact that the iliac crests are at different heights. Opinions about the causes of scoliosis are very controversial. In childhood, these disorders are usually not accompanied by either pain or limitation of mobility. In girls, if the curvature is very noticeable, psychological trauma often occurs . In adults, depending on the degree of development of scoliosis due to degenerative changes, shingles of irradiating nature may occur due to mechanical irritation passing in the segment of the nerve root; it can even go as far as limiting working capacity when involved in the process of the cardiovascular system and lungs as a result of organ compression.
The treatment is multifaceted and individual; it depends on the degree of curvature of the spine, the age of the patient, the causes of development and severity of symptoms, as well as the general condition of the patient. These factors also determine the results of treatment, however, it should be based on the principle that the already formed deformations do not undergo a reverse development, that is, they cannot be treated.
First, conservative methods are used. The focus should be on issues of psychosomatic treatment, as well as activation of blood supply to the affected area and an overall improvement in metabolic processes. To enhance the effect, orthopedic auxiliary equipment can be used, and the general indication for their use is the need to reduce the load on the affected organ or limb. Drug treatment is prescribed depending on the complications. Food should be full and rich in vitamins. If the cause of scoliosis is known, then all efforts should be directed to its elimination.