What is osteochondrosis of the thoracic spine kyphoscoliosis. Treatment of kyphoscoliosis of the thoracic spine

In scoliosis, the spine is curved to the right or left side, with kyphosis - the bend increases posteriorly.

Prolonged sitting negatively affects posture. In children with an incorrect posture, scoliosis develops first, and then kyphosis is added to it. The disease is more common among boys than girls.

To compensate for the load, there are several curved sections in the spine, which, according to external signs, are absent in a person. Due to unfavorable factors, these areas are more strongly curved, which can lead to a violation of not only the entire spine, but also individual intervertebral discs. As a result, kyphoscoliosis may develop.

Causes of kyphoscoliosis

Scoliosis and kyphosis develops mainly in children during growth. If the spinal muscles are injured or intervertebral discs, the development of kyphoscoliosis is possible. The main cause of the congenital form of the disease is possible anomalies of intrauterine development.

The most common causes of kyphoscoliosis are:

• Prolonged sedentary work at the computer
• Wrong way of life
• Overweight
• Various injuries of the back and spine
• Osteochondrosis
• Postponed spinal surgery
• hereditary predisposition
• Polio
• Psychological stress

Appearance this disease adversely affects work internal organs. Kyphoscoliosis strongly affects the reduction of lung volume, due to a decrease in the mobility of the diaphragm. With a lack of oxygen, gas exchange in the lungs is disturbed, as a result of which pulmonary insufficiency. It affects the activity of the heart and blood circulation.

Classification and degrees

Violation of posture can be congenital or acquired. The congenital form of kyphoscoliosis is a developmental pathology of the vertebrae. The cause of the disease can also be the formation of extra or fused ribs.

Already in the first years of life, a child can be diagnosed with a disease. congenital disease may be accompanied by the appearance of neurological disorders. Already by 6-8 months, when the child begins to sit, the curvature is noticeable.

When kyphoscoliosis is detected on early stages development, the disease is easily treatable.

Many factors influence the development of acquired kyphoscoliosis. The disease can appear as a result of an injury to the back and individual vertebrae, inflammatory process, diseases of the musculoskeletal system, underdevelopment bone structures etc.

There are 4 forms of kyphoscoliosis:

1. hereditary kyphoscoliosis
2. Postoperative kyphoscoliosis
3. Post-traumatic kyphoscoliosis
4. Idiopathic kyphoscoliosis

hereditary form diseases can manifest themselves and be transmitted through several generations.

Postoperative kyphoscoliosis develops after surgical intervention on the spine. It usually occurs when the doctor's recommendations and the regimen after the surgery are not followed.

Post-traumatic kyphoscoliosis occurs after an injury. The disease can appear due to a fracture of the spine in thoracic region.

If it is not possible to establish the cause of the development of the disease, then a diagnosis is made idiopathic kyphoscoliosis. This is the diagnosis given to adolescents.

There are the following degrees of kyphoscoliosis:

• 1 degree. Characterized by slight lateral curvature, usually in right side, as well as slight twisting.
• 2 degree. It has a pronounced lateral deviation and noticeable twisting.
• 3 degree. Characterized by the development of the costal hump and deformation chest.
• 4 degree. Deformation undergoes the spine, chest and pelvic bones. An anterior and posterior hump is formed.

Treatment is prescribed by an orthopedist, taking into account the form and degree of the disease.

Symptoms of kyphoscoliosis

The main signs indicating the development of kyphoscoliosis:

• Pain in the shoulder blades
• Slouch
• Numbness and cramps
• Dizziness
• Shortness of breath after exercise
• Weakness
• Fast fatiguability
• Heartburn
• constipation
• Urinary incontinence
• Violations at work of cardio-vascular system

In most cases, the disease is accompanied by neurological insufficiency.

in congenital kyphoscoliosis six months old baby you can see the hump. The curvature of the spine is noticeable if the patient is in an upright position. Deformation spinal column disappears in the supine position. If the disease is not treated, then the curvature will be noticeable in any position of the child.

When the first symptoms appear, you should immediately contact an orthopedist.

Complications

Depending on the physiological characteristics body, the shape of the spinal column may not correspond to the desired parameters. For this reason, the muscles that are located near the spinal column, as well as all parts of the spine, experience constant congestion.

Kyphoscoliosis can lead to early osteochondrosis, the appearance of myositis. Protrusion may also be observed. intervertebral disc and arthrosis of the joints.

A severe form of scoliosis is a prerequisite for dysfunction of the cardiovascular system and lungs. In addition, there is a malfunction in the work of organs digestive system: reduced functions individual bodies, their position is disturbed. The patient has an increased risk of developing inflammation, impaired motility and tone of the gallbladder.

Diagnostics

Kyphoscoliosis is treated by an orthopedist, but it is recommended to consult a neurologist to make an accurate diagnosis. Qualified specialists will examine the patient, assess the degree of deformation of the spinal column in different positions, the sensitivity and reflexes of the tendons.

In children, a direct and lateral radiograph of the spine is prescribed to determine kyphoscoliosis.

If necessary, it is possible to conduct magnetic resonance imaging and computed tomography.

Treatment

It is possible to completely eliminate the disease only in childhood because in children the skeletal system is more flexible than in adults. However, properly selected treatment will help alleviate the patient's condition and reduce the manifestations of the disease.

Treatment of kyphoscoliosis will be effective and successful when contacting a doctor at the initial stage of the development of the disease. Depending on the degree and form of kyphoscoliosis, the age of the patient, conservative or surgical treatment is prescribed.

Conservative treatment of kyphoscoliosis involves performing special exercises and using a corset. In the early stages of the disease (grade 1 and 2), it is necessary to perform exercises physiotherapy exercises using a corset. Physiotherapy helps to strengthen the muscles of the back, abs, and shoulder girdle.

The corrective corset can be used as a medical device for fixing the spine. It consists of a frame that repeats the profile of a person and is located along the back. The corset has a fastening system with upper and lower belts that cover the human body horizontally. Corsets are made for each individually.

To improve blood circulation, increase muscle flexibility, activate metabolic processes physiotherapy is prescribed in the tissues: massage, acupuncture, kinesiotherapy, manual therapy, etc.

Patients are not contraindicated for moderate exercise and swimming, with the exception of volleyball and basketball.

On the late stages development of the disease, when the curvature of the spine is noticeable, then they resort to surgical intervention.

The main indications for the operation:

• Pronounced pain syndrome;
• The rapid development of the pathological process;
• Visible neurological disorders;
• The bending angle of the curvature is more than 45 degrees.

The operation consists in installing special hooks in the vertebrae. To align the spine, special rods are used, which are attached to hooks.

This procedure corrects the curvature of the spinal column, improves the balance of the body, and increases the volume of the chest. All this contributes to an increase in the vital capacity of the lungs.

Prevention

A patient with kyphoscoliosis should regularly engage in therapeutic exercises, perform special exercises, and eat right.

Therapeutic exercises should be performed only those recommended by the doctor. It is important to ensure that they are carried out correctly. Sample exercises:

1. In the prone position, lift the straight right leg up and lower down towards the left leg. At the same time, make sure that the inner surface of the right leg touches the floor. Run with the other leg.
2. Lie on your stomach, slowly raise your legs, first one and then the other. The lower back can be slightly bent.
3. Stand with your back to the wall and take a step forward. Next, put your feet shoulder-width apart, bend your knees slightly. It is necessary to bend back, while trying to touch the back of the head to the wall. Stay in this position for 10-20 seconds. Repeat 2-3 times.
4. Standing, raise your hands up and clasp in the castle. Stretch your arms up as you inhale and stand up on your toes a little, then slowly lower as you exhale. Perform the exercise 5 times.
5. Tilts of the body to the left and right with the sliding of the hand over the leg. When tilted, the opposite hand rises up.

1. Sleep on a hard bed and preferably on your back.
2. You need to move more.
3. Standing on one leg is not recommended.
4. You should sit straight.
5. Carrying bags on one shoulder is prohibited, distribute the load evenly.
6. Do not lift weights or jump.

In order to prevent the progression of the disease, it is important to teach the child to play sports from childhood and follow the above recommendations.

Forecast

It is possible to eliminate the disease and get rid of a cosmetic defect during the period of active growth of the child. It takes into account the degree of curvature, and the rate of progression of the disease.

In many cases, kyphoscoliosis 1 degree can be completely eliminated. If all the doctor's recommendations are followed and exercises are performed, most patients experience a significant straightening of the spinal column. Last stages disease progression is less favorable for patients. Only adequate treatment can stop the progression of kyphoscoliosis and, in some cases, correct posture. It is impossible to fully straighten the spine at stage 4 of kyphoscoliosis.

Therapeutic measures aimed at eliminating kyphoscoliosis should be carried out in a timely manner. It is necessary to pay attention to signs of curvature and stoop even in childhood, so as not to start the disease.

- This is a combined deformity of the spine, which is a combination of scoliosis (lateral bending) and kyphosis (stooping, excessive bending in the anteroposterior direction). It can be congenital or acquired, manifested by visible deformity and back pain. Due to the secondary change in the shape of the chest and dysfunction of the organs located in it, shortness of breath and cardiac disorders are possible. The diagnosis is made on the basis external signs, X-ray data, MRI and CT. Treatment of kyphoscoliosis is usually conservative, with severe curvature may require surgery.

General information

Kyphoscoliosis is a simultaneous curvature of the spine in the lateral and anteroposterior directions. It is a fairly widespread pathology, in most cases occurs in adolescence. Boys are affected four times more often than girls. In mild cases, kyphoscoliosis can cause fatigue and back pain. Severe pathology has a negative impact on the state of the whole organism, can cause neurological disorders, worsen the functioning of the lungs, heart and digestive system.

Causes of kyphoscoliosis

The cause of the development of congenital curvature is usually anomalies in the development of the vertebrae. In 20-30% of cases, the deformity is combined with malformations genitourinary system. In this case, the pathology is often not detected immediately, but at the age of 6 months and older (when the child begins to walk or stand). At the same time, cases were recorded when grade 3 kyphoscoliosis was detected immediately at the birth of a baby.

Among the factors that can lead to the formation of acquired kyphoscoliosis is congenital insufficiency. connective tissue, rickets, some diseases of the spine (osteochondropathy, tumors, Scheuermann-Mau disease, etc.). In addition, the cause of the development of kyphoscoliosis is a violation of muscle tone and muscle function due to myopathy, myodystrophy and paralysis (for example, with poliomyelitis or cerebral palsy), rheumatism (due to damage to the cartilaginous tissue of the spine by antibodies), a discrepancy between the rate of development of bone and muscle tissue during the period of active growth, etc. Most often, the symptoms of acquired kyphoscoliosis appear at the age of 13-15.

Predisposing factors that increase the likelihood of developing kyphoscoliosis are excessive stress on the spine due to being overweight or hard physical work, as well as a “sedentary” sedentary lifestyle and incorrect body position when working at a computer, sitting at a desk, etc.

Pathoanatomy

Normally, the human spine has several curves in the anteroposterior direction: one curve back (thoracic kyphosis) and two curves forward (lumbar and cervical lordosis). These bends play a compensatory role in case of vertical loads on the spinal column. If the spine bends back more than normal (at an angle of more than 45 degrees), they speak of pathological kyphosis. Usually, pathological kyphosis develops in the same place as physiological kyphosis - in the thoracic region. The human spine normally does not have lateral bends, therefore, with any degree of lateral curvature, scoliosis is diagnosed. As a rule, at the initial stage of the formation of kyphoscoliosis, kyphosis is formed, and subsequently scoliosis joins it.

Classification

Depending on the severity of the deformation, 4 degrees of kyphoscoliosis are distinguished:

• 1 degree kyphoscoliosis - the angle of curvature of the spine in the anteroposterior direction is 45-55 degrees. There is a slight lateral displacement and twisting (rotation) of the vertebrae.
• 2 degree kyphoscoliosis - the angle of curvature of the spinal column in the anteroposterior direction is 55-65 degrees. There is noticeable twisting and lateral displacement.
• 3 degree kyphoscoliosis - the angle of curvature of the spine in the anteroposterior direction is 65-75 degrees. A vertebral hump is formed, a visible deformity of the chest is noted.
• 4 degree kyphoscoliosis - the angle of curvature of the spinal column in the anteroposterior direction is more than 75 degrees. As in the previous case, the curvature is accompanied by the formation of a vertebral hump and deformity of the chest.

Taking into account the direction of the lateral curvature in orthopedics and traumatology, left-sided and right-sided kyphoscoliosis are distinguished.

Symptoms of kyphoscoliosis

Congenital pathology, as a rule, becomes noticeable after 6-12 months. A barely noticeable hump forms on the back of the child, while, unlike "pure" scoliosis, with kyphoscoliosis, the protrusion of not the muscle roller, but the spinous processes of several vertebrae, is revealed. In the early stages, the curvature of the spinal column is noticeable only when moving to a vertical position and disappears in the supine position. Subsequently, kyphoscoliosis becomes persistent, independent of body position. In about 50% of cases, kyphoscoliosis is accompanied by progressive neurological failure. At a younger age, sensitivity disorders are detected, in adolescents with congenital kyphoscoliosis, the development of rapidly progressive paresis is possible.

Early manifestations of adolescent kyphoscoliosis are changes in posture, increased stoop, and back pain. Often, a child begins to complain of pain or discomfort in the back even before the parents notice a violation of posture. It is also possible mild dyspnea, resulting from the restriction of chest excursions. Neurological disorders in adolescent kyphoscoliosis are less common and, as a rule, occur only with severe deformities. The rate of progression can vary significantly depending on the cause of kyphoscoliosis, as well as the timeliness and adequacy of treatment.

An external examination reveals an increased stoop (round back), in severe cases - a hump. Top part the torso and shoulders of a patient with kyphoscoliosis are tilted forward and down, there is a narrowing of the chest and weakness of the abdominal muscles. To detect scoliosis, the doctor performs an examination in a position with a straight and bent back. In the presence of scoliotic deformity, a deviation of the spine from the midline is detected. An external examination of the chest determines the expansion of the intercostal spaces on the side opposite to the lateral curvature. With kyphoscoliosis complicated by neurological disorders, a local decrease in sensitivity, a change in tendon reflexes, and asymmetry in muscle strength are detected.

Complications

The discrepancy between the shape of the spinal column and the physiological needs of the body causes a constant overload of all structures of the spine and paravertebral muscles. Possible with kyphoscoliosis early development osteochondrosis, the formation of disc protrusions and intervertebral hernias, the occurrence of myositis and arthrosis of the joints of the spine. Some of the listed pathological processes can cause pressure spinal cord and its roots and lead to the appearance neurological symptoms(disturbances of sensitivity, movement disorders dysfunction of the pelvic organs).

Due to kyphoscoliosis, the mobility of the chest and diaphragm is limited. This leads to an increase in the load on the respiratory muscles, a decrease in the extensibility of the lung parenchyma and a decrease in the functional residual capacity of the lungs. As a result, the volume of the lungs decreases, gas exchange is disturbed: there is more carbon dioxide and less oxygen. With severe kyphoscoliosis, a visible deformity of the chest occurs, entailing even more significant impairment of the function of the lungs and heart.

In severe kyphoscoliosis, not only the heart and lungs suffer, but also digestive tract: the location of the organs is disturbed, their functioning worsens. The likelihood of cholecystitis and biliary dyskinesia increases. Due to kyphoscoliosis, there is a redistribution of the load on lower limbs develop early coxarthrosis.

Diagnostics

The diagnosis of kyphoscoliosis is made on the basis of external signs and X-ray data of the spine. If necessary, along with the two main projections, images in special positions (lying, standing, stretching the spine) can be assigned. To clarify the diagnosis, the patient can also be referred for MRI and CT of the spine. An examination for kyphoscoliosis provides for a mandatory consultation with a neurologist. If a violation of the function of the internal organs of a patient with kyphoscoliosis is suspected, they are sent for consultations to the relevant specialists: cardiologist, pulmonologist, gastroenterologist, urologist.

Treatment of kyphoscoliosis

Treatment is carried out by vertebrologists and orthopedists with the participation of neuropathologists and other specialists (depending on the identified concomitant pathology). The main methods of conservative correction of kyphoscoliosis are corseting and therapeutic exercises. A set of exercises is selected individually. With grade 1 kyphoscoliosis, it is often enough to perform exercises regularly to straighten the spine; with grade 2, exercise therapy must be combined with wearing a corset. Custom-made corrective corsets are used. In most cases, in the process of corseting, along with the elimination of stoop, derotation is performed (elimination of rotation of the spine along the axis).

To improve blood circulation, increase muscle plasticity and activate metabolic processes in muscle tissue, patients with kyphoscoliosis are prescribed massage. Useful swimming and moderate exercise (subject to existing contraindications). Classes with weights and "jumping" sports (long and high jumps, volleyball, basketball) are contraindicated.

Indications for surgical treatment are grade 4 kyphoscoliosis, severe pain, progressive neurological disorders, deterioration of heart and lung functions. Surgical correction for kyphoscoliosis involves the installation of special metal structures (hooks, screws) in the vertebrae and alignment of the spinal column using special rods that are attached to these metal structures. In this case, the fixed section of the spine loses its mobility.

Forecast and prevention

Complete elimination of kyphoscoliosis is possible before the end of the active growth of the child, that is, up to 14-15 years (some experts consider the age of 12-13 years to be critical), while the degree of curvature and the rate of progression of the disease matter. In most cases, it is possible to completely eliminate kyphoscoliosis of the 1st degree; in a significant proportion of patients, it is possible to achieve straightening of the spine with kyphoscoliosis of the 2nd degree. With kyphoscoliosis of 3 and, especially, 4 degrees, the prognosis is less favorable - adequate treatment, as a rule, makes it possible to stop the progression of the deformity and, in some cases, to carry out a partial correction. Complete straightening of the spinal column in such cases is extremely unlikely.

In the treatment of kyphoscoliosis, the timeliness of all ongoing medical measures. Insofar as effective correction kyphoscoliosis is possible only as long as the child continues to grow, it is very important to pay attention to the signs of kyphoscoliosis in time, immediately seek medical care and accurately follow all the recommendations of the doctor, especially in relation to therapeutic exercises and wearing a corset. It is these methods that make it possible to eliminate kyphoscoliosis, while other methods of treatment perform only a secondary auxiliary function.

is a disease that combines scoliosis and kyphosis. In this case, the curvature of the spine in the thoracic region is characteristic in two directions at once: lateral and anterior-posterior. A similar double spinal deformity is usually diagnosed in male children. The disease is treatable if you start treatment at a young age, immediately after the diagnosis is established, but, unfortunately, the initial stage appears outwardly and looks like a simple stoop.

The causes of this disease are:

• the occurrence of pathology during fetal development;
• heredity;
• acquired kyphoscoliosis.

In the case of the development of a pathology not related to heredity or congenital causes are:

• frequent sitting in one position;
• incorrect posture;
• consequences of spinal injury;
• spinal surgery;
• uneven physical activity (heavy bag on one shoulder);
• the presence of tumors;
• rickets, osteochondrosis and other diseases of the musculoskeletal system;
• diseases of the muscular system;
• psychological factors.

Attention! Children are most susceptible to acquired kyphoscoliosis. school age, in boys it occurs 4 times more often.

Not yet fully formed musculoskeletal system in combination with a long stay in one position, carrying a heavy briefcase gradually lead to a disease of the spine. The psychological discomfort of the child due to his long growth causes stoop, kyphosis, which can also lead to kyphoscoliosis.

If the pathology occurs for unknown reasons, then this type of kyphoscoliosis is called idiopathic, it is mainly diagnosed in the preadolescent period.

Attention!Kyphoscoliosis affects the functioning of internal organs: reducing the volume of the lungs, which causes a lack of oxygen.

The degree of development of the disease

Kyphoscoliosis has four degrees, they are subdivided depending on the degree of deformation of the spine and the angle of its curvature. Clinical picture disease will change with the progression of pathology.

1. First degree. Characterized this stage is a slight displacement of the vertebrae with slight twisting, the angle of curvature is up to 55°. There are no noticeable deviations of the spinal axis yet.
2. Second degree is a more pronounced deviation of the spine with more pronounced twisting, the angle of curvature of the spine up to 65. The patient suffers from shortness of breath and is accompanied by back pain.
3. At third degree irreversible processes begin. The chest is noticeably deformed, the costal hump becomes visible with an angle of curvature of the spine up to 75°. Against this background, there is an increase in shortness of breath, pain in the heart appears.
4. And fourth degree- the most difficult form of pathology for treatment, when the deformation processes affected the chest, spinal column and pelvis at the same time. A hump is formed in front and behind, with an angle of curvature of the spine from 75 °. Man experiencing severe pain, which are accompanied by periodic numbness of the limbs.

The spine can be bent to the left or right side, depending on this, the pathology will be called right- or left-sided.

On a note! At the last - fourth stage, signs of heart failure appear, cor pulmonale syndrome develops.

Symptoms

Illness at congenital pathology can be found in a child by the age of one, when he begins to stand or walk. Timely recognition of pathology at an early stage gives a very high chance of treatment. Therapy does not become costly or complicated, it is enough for physiotherapy exercises prescribed by the doctor.

Pathology is manifested in the visibility of the processes of the vertebrae when the baby is standing or sitting, which disappear in the prone position. The disease progresses rapidly if no action is taken. In young children of 4-5 years of age, kyphoscoliosis of the 4th degree occurs.

At initial stage the development of acquired pathology in older children and adolescents, the disease practically does not manifest itself. Possible rapid fatigue physical activity. But with the progression of the disease, the following symptoms appear:

• visual change in posture;
• pain in the back, scapular region;
• dizziness;
• increased stoop;
• dyspnea;
• diseases of the digestive tract;
• muscle weakness;
• limb numbness.

Numbness of the legs and arms occurs due to pinching of the nerves of the spinal cord with deformed vertebrae.

The internal systems of the body are affected in the later stages of the disease, when the negative impact of the pathology extends to such organs as: lungs, heart, stomach, intestines. In the later stages of pathology are possible:

• damage to the cardiac system;
• development of pulmonary hypertension;
• violation of motility of the gallbladder;
• displacement of some organs.

It is also possible complications in the disease of the thoracic spine in the form of arthrosis and osteochondrosis.

Important! In very severe cases, the disease occurs with sexual dysfunction, urinary or fecal incontinence occurs.

Diagnosis and treatment

Neurologists and orthopedists help to assess the stage of kyphoscoliosis and the patient's condition. Also, a visual examination by the surgeon will not be superfluous. If you need to establish a more accurate diagnosis, you will need to consult a cardiologist, gastroenterologist. Laboratory research include blood and urine tests.

Deformation, its degree is determined using:

• X-ray methods of research;
• computed tomography;
• magnetic resonance imaging;

The patient is assigned an electrocardiogram, which determines the condition functional diagnostics in the cardiovascular system.

In the treatment of the disease, massage is used, a set of therapeutic exercises, which are individually selected by the doctor, is also used:

• acupuncture (acupuncture);
• stretching of the spine;
• physiotherapy.

All these conservative methods aimed at strengthening the muscles of the back, reducing the load on the spine. Except listed ways treatment includes:

• wearing a special corset;
• taking anti-inflammatory drugs;
• taking medications that accelerate the restoration of cartilage tissue.

The effect of conservative treatment

The methods work effectively at certain stages of diseases and contribute to the cessation of spinal deformity. In advanced cases, radical or surgical intervention is already required.

Important! Reception of specific medications may be necessary only as prescribed by a doctor!

Indications for surgery in case of pathology:

• the fourth degree of the disease;
• progressive complications;
• pronounced pain syndrome;
• violations of the functionality of internal organs.

Correction of the thoracic spine can be carried out by fixing the vertebrae with special rods. The design is created individually, taking into account the structure of the spine. Rehabilitation after surgery takes a long period.

Preventive measures and prohibitions for kyphoscoliosis

Kyphoscoliosis in the early stages can be stopped if timely attention is paid to it. What is needed in this case:

• physical activity;
• swimming;
• correct posture;
• hard bed;
• rest and sleep on the back;
• healthy eating;
• exclusion of excessive load on the spine.

Prohibited in pathology:

• to take dance classes;
• play volleyball, basketball;
• load constantly one arm and one shoulder;
• work with dumbbells;
• stay in one position for a long time.

You will also need to pay attention to your diet. It should be rich in vitamins and minerals. Calcium, potassium, magnesium, B vitamins and others needed for normal development and the functioning of the skeletal system, substances must be ingested daily.

Video - Kyphoscoliosis: symptoms and treatment of the disease

Video - Exercises for kyphoscoliosis

The spine, if properly formed, has slight natural curves. When viewed from the side in the thoracic and sacral regions, it bends backward, and in the cervical and lumbar regions it bends forward. Thanks to this structure, the spine is able to bend and absorb. However, there are cases when at birth or after a while the posture is bent, the vertebral bend deviates from the norm. Moreover, changes can occur in several directions. This deformity is more severe and more difficult to treat. Most often among this kind of pathologies, kyphoscoliosis of the thoracic spine occurs.

What is kyphoscoliosis

Kyphoscoliosis is a pathological disease, which is characterized in two planes at the same time: in the anteroposterior and lateral, that is, 2 pathologies - kyphosis and scoliosis - are combined together.

Adolescents are most susceptible to kyphoscoliosis. As the statistics show, this pathology 4 times more common in boys than girls. If kyphoscoliosis of the chest is noted in an adult, this means that the curvature was not cured in childhood, and gradually, due to the development of scoliosis and kyphosis, the spine underwent deformation.

Causes

The underlying causes of the disease are:

. Relaxation of the back muscles. If the physical development of the child is insufficient, the muscles are not able to adapt to enhanced growth of the spine, which can lead to a modification of the vertebrae themselves, followed by deformation of the spine.

. Passive lifestyle. Crooked posture at the table, along with the lack of physical activity, provokes the onset of the curvature of the spine.

. Problems of a socio-psychological nature. Stoop often develops against the background of a reflex attempt by the body to protect itself from exposure external factors. Often this problem is associated with high growth, emotional overload, the constant influence of others.

. Great physical activity. Excessive force loads on the pectoral muscles in the absence of a well-developed musculoskeletal apparatus can cause stoop in adolescents and make the chest hollow.

. Uneven loads on different parts of the body. Some sports exercises develop only one muscle group without affecting the rest, which can lead to deformation of the spinal column in one direction or another.

In addition to the above, factors such as psychological stress, trauma and surgery on the spine, diseases can also provoke kyphoscoliosis of the thoracic spine. musculoskeletal system(cerebral palsy, poliomyelitis, osteochondrosis, tumors).

The causes of the disease may be associated with abnormal intrauterine development of the child, and also be hereditary.

Classification

Depending on the causes that provoked the disease, the types of the disease are distinguished.

Congenital kyphoscoliosis. Associated with the abnormal formation of individual vertebrae, as well as the formation of fused or extra ribs. Such a disease, as a rule, can be detected in a child at the age of 6 months and it is not difficult to cure it in the early stages of development.

hereditary kyphoscoliosis. It differs in the same character of development in a number of generations and is inherited according to the dominant type.

Acquired kyphoscoliosis. Appears due to incorrect posture, psychological stress, trauma and surgical manipulations on the spine, certain diseases of the musculoskeletal system.

Idiopathic kyphoscoliosis. This diagnosis It is established in cases where the cause of the curvature of the spine cannot be determined. The most common form of idiopathic scoliosis develops in adolescents at the stage of accelerated growth (11-15 years).

How dangerous is this disease

Kyphoscoliosis of the spine, if left untreated, can adversely affect the functioning of internal organs, primarily the respiratory system. When the mobility of the chest is impaired, the lungs shrink in volume, the load on the respiratory muscles increases, insufficient gas exchange occurs, followed by a decrease in the level of oxygen in the blood. As a result, pulmonary and even heart failure develops.

Pathological changes in the ridge cause constant congestion of its structures, as well as paravertebral muscles. Therefore, kyphoscoliosis often leads to osteochondrosis, the formation of intervertebral protrusions and hernias, which is a trigger for the development of neurological diseases.

In addition, kyphoscoliosis can lead to damage to the genitourinary system.

Symptoms

The main signs of kyphoscoliosis are:

• stoop when sitting and walking;
• drawing pains in the muscles of the neck and back;
• pain in the back, especially after a long stay in one position;
• dizziness, weakness and fatigue;
• pain in the heart, arrhythmia;
• shortness of breath with great physical exertion.

The last stages of the development of the disease are also characterized by the pelvis. The patient has impaired coordination of movements, which can lead to loss of mobility.

Diagnostics

If you suspect a curvature of the ridge, you should visit an orthopedic traumatologist, in some cases, you may need the help of a neurologist. To establish the diagnosis of "kyphoscoliosis", first of all, the specialist performs an external examination: assesses the degree and nature of the curvature, checks the strength muscular apparatus, tendon reflexes and skin sensitivity.

If a deformity is suspected, it is done in different projections. For more accurate diagnosis sometimes you have to resort to such methods of examination as CT and MRI.

Stages of the disease

Kyphoscoliosis of the spine 1 degree. Accompanied by slight lateral displacement and slight twisting. The skew angle in this case does not exceed 55 °.

Kyphoscoliosis of the thoracic spine, grade 2. In this case, the back has a more pronounced lateral curvature and twisting.

Kyphoscoliosis grade 3. It is characterized by deformation changes in the chest and the formation of a costal hump.

Kyphoscoliosis 4 degrees. There is a curvature not only of the ridge and chest, but also of the pelvic bones.

Based on the nature of the lateral shift of the spine, left-sided and right-sided kyphoscoliosis of the thoracic spine are distinguished.

Treatment Method

Depending on the stage of development of kyphoscoliosis, conservative and surgical therapy is used.

Usually, initial stages curves fit well conservative treatment. One of the main areas of prevention and conservative treatment of kyphoscoliosis is therapeutic Physical Culture. Exercise therapy for kyphoscoliosis of the thoracic spine consists in the use of a number of special exercises aimed at shaping and strengthening the muscle corset, as well as relaxing and stretching certain muscle groups. All this is prescribed individually by the attending physician.

Exercises for kyphoscoliosis of the thoracic spine should be performed under the supervision of an exercise therapy instructor, because the effectiveness of the therapeutic measure depends on the correctness of their implementation.

Apart from exercise, as conservative therapy patients are prescribed wearing corrective orthopedic corsets, physiotherapy, acupuncture, kinesitherapy, massotherapy, painkillers and anti-inflammatory drugs.

The surgical method is used for extremely severe deformities (kyphoscoliosis of the thoracic spine, grade 3, and also 4). In this case, osteoplastic surgery is performed or resorted to surgical correction endocorrectors. The last option is used most often. Its essence lies in fixing the spine with the help of metal structure, which is modeled under its physiological curves. After such an operation, patients need a long rehabilitation.

Preventive actions

In order to prevent and prevent the development of spinal pathology, it is necessary to adhere to certain rules:

Sleep on a hard mattress. At the same time, sleeping on your back, and not on your side, is considered the best for posture.

When carrying a bag, do not load the same shoulder. In this case, it is better to prefer a backpack so that the load is distributed evenly.

Arrange workplace so that it contributes to maintaining the correct posture.

With a tendency to kyphoscoliosis, it is contraindicated to lift weights, stand and jump on one leg.

Kyphoscoliosis is a very unpleasant disease that causes significant pain and can be fraught with serious complications. That is why it is so important to prevent the appearance and development of this disease. If, nevertheless, the symptoms made themselves felt, you should not delay, you should immediately seek help from a specialist.

Kyphoscoliosis is a disease of the spine that combines the curvature of the spine (scoliosis) and kyphosis (stoop). The angle of bending in kyphoscoliosis is more than 45 degrees. Depending on the direction in which the spine is bent, right-sided kyphoscoliosis (right bend) and left-sided kyphoscoliosis (left bend) are distinguished.

Often kyphoscoliosis develops in children aged 13-15 years in the process of growth without any apparent reason. Posture is negatively affected by the sitting position during the training period. Moreover, scoliosis develops first, and then kyphosis joins. In boys, kyphoscoliosis occurs 4 times more often than in girls.

Kinds

At congenital kyphoscoliosis the disease may not manifest itself until the child reaches the age of six months. The first signs are subtle deformity in the spine, which increases with time. Congenital kyphoscoliosis of the thoracic spine is characterized by an aggressive course and can progress rapidly. In 20% of cases, the disease is combined with anomalies in the development of the genitourinary system. A child with an established diagnosis should be carefully examined for the presence of additional pathologies.

Adolescent (youthful) kyphoscoliosis develops in adolescence from 13 to 16 years. As a rule, scoliosis is formed first, and later kyphosis joins it. Sometimes the situation develops differently - scoliosis is connected to kyphosis.

The main cause of teenage kyphoscoliosis is poor posture. Most often, it is formed with an incorrect organization of the workplace of a teenager, the habit of sitting at a desk, hunched over. Sometimes kyphoscoliosis develops in tall children who psychologically want to appear shorter. As a result, they first have a stoop - kyphosis, and with the progression of the process, scoliosis is added.

According to statistics, kyphoscoliosis develops in girls 4 times less often than in boys.

Degrees

Depending on the severity of the process, 4 stages of the disease are distinguished:

1. kyphoscoliosis 1 degree characterized by minimal deviations in the bending of the spine and its twisting;
2. kyphoscoliosis grade 2- more pronounced lateral deviation and tortuosity indicate the progress of the disease;
3. kyphoscoliosis grade 3- the chest begins to deform, and a costal hump appears;
4. kyphoscoliosis grade 4 characterized by severe deformity of the spine, chest and even the pelvis.

Launched kyphoscoliosis can lead to serious consequences up to disability. In the course of the disease, the mobility of the chest and diaphragm is significantly reduced, which is expressed in a decrease in the vital volume of the lungs and impaired respiratory function.

Subsequently, the saturation of tissues with oxygen decreases, this leads to the formation of a dangerous condition called cor pulmonale. It manifests itself in an increase in the right ventricle of the heart and is accompanied by severe shortness of breath, pain in the heart and other symptoms of heart failure. Pulmonary heart syndrome is an irreversible and severe consequence. The life expectancy of patients suffering from cor pulmonale is reduced by 10 years.

To make a diagnosis and clarify the stage of the disease, it is necessary to make an x-ray of the spine in different planes, magnetic resonance imaging and computed tomography.

Causes

The disease may be congenital and acquired. The cause of congenital kyphoscoliosis is a violation of intrauterine development.

Causes of acquired kyphoscoliosis:

• poor posture due to a sedentary lifestyle, working at a computer;
• the consequences of poliomyelitis or cerebral palsy - the most common cause of kyphoscoliosis;
• consequences of injury;
• osteochondrosis;
• spinal tumors;
• genetic predisposition.

The main known cause of kyphoscoliosis is childhood polio.

In 80% of cases, the causes of kyphoscoliosis remain unexplained.

Symptoms

• shortness of breath during physical exertion is one of the first symptoms of kyphoscoliosis, its severity depends on the degree of the disease. Shortness of breath is due to a decrease in lung volumes due to stiffness of the chest;
• slouch;
• back pain;
• sensory disturbances in the legs;
• fast fatiguability;
• disruption of the cardiovascular system - in the later stages of the disease;
• urinary incontinence.

Diagnostics

For a successful diagnosis of kyphoscoliosis, it is necessary to undergo an examination by an orthopedist and a neurologist. During the examination, specialists assess the deformation of the spine in different positions, tendon reflexes, skin sensitivity, muscle strength of the back, neck, arms and legs.

To determine the angle of deformation, an x-ray is taken. Sometimes it is done in several positions (standing, lying down, while stretching the spine). Also, to clarify the diagnosis, magnetic resonance imaging (MRI) may be prescribed and computed tomography(CT).

Treatment

Depending on the degree of the disease, conservative and surgery kyphoscoliosis.

With kyphoscoliosis 1 and 2 degrees efforts should be aimed at creating a muscular corset and improving joint mobility. Treatment includes massage, manual therapy, therapeutic gymnastics, physiotherapy, acupuncture.

Kyphoscoliosis grade 3 and 4- treated surgically. Metal rods are used to fix the spine in the correct position. After surgical treatment the patient is forced to stay in a plaster corset for several months. Even after a successful surgical intervention, the volume of the lungs will remain at the level prior to the operation.

To prevent development severe consequences kyphoscoliosis, it is necessary to form the correct posture in the child from early childhood. Regular sports, the organization of the student’s workplace are very effective means prevention of acquired kyphoscoliosis.

Sincerely,