Kyphoscoliosis, Kyphoscoliosis Of The Thoracic Spine

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Kyphoscoliosis

The content of the article:

1. Causes and risk factors
2. Forms of the disease
3. Disease stages
4. Symptoms
5. Diagnostics
6. Treatment of kyphoscoliosis
7. Complications
8. Forecast
9. Prevention

Kyphoscoliosis (Greek kύφο - bent, humped and Greek σκολιός - curve) is an orthopedic pathology, which is characterized by a combined curvature of the spine in the frontal (around the longitudinal axis) and sagittal (conventionally dissecting the human body from front to back) planes.

Kyphoscoliosis is manifested by the bulge of the spine back and sideways and by rotation of the vertebrae (turning relative to each other). In addition to impaired posture, kyphoscoliosis leads to serious damage to the spine and disruptions in the functioning of various organs and systems, in particular the respiratory: reduced lung volumes, increased load on the respiratory muscles, reduced distensibility of the lung tissue, chest stiffness may be observed.

Pathology is common among school-age children, and it occurs more often in boys than in girls. The development of kyphoscoliosis in adults indicates the process of spinal deformity under the influence of kyphosis or scoliosis, which were not cured in childhood.

Causes and risk factors

The following reasons can lead to different forms of kyphoscoliosis:

• genetic predisposition;
• underdevelopment of bones and joints;
• violation of muscle tone due to myopathy and paralysis;
• deformation of the vertebrae;
• polio;
• rickets;
• mechanical trauma to the vertebrae;
• inflammatory processes that affect the development of bone and joint tissues;
• surgical intervention (postoperative kyphoscoliosis);
• paresis;
• tick-borne encephalitis;
• tuberculous lesion of several vertebrae or part of the spinal column;
• the development of diseases of the spine (tumors, osteochondropathy);
• professional posture disorders, sedentary lifestyle;
• heavy physical activity;
• consequences of radiation therapy.

Forms of the disease

Depending on the cause of the development of pathology, the following forms are distinguished:

• congenital kyphoscoliosis - appears as a result of violations of the laying of individual ribs and vertebrae at the stage of intrauterine development, often combined with malformations of the genitourinary system; manifests itself in infants already in the first six months of life in the form of a small hump, progresses rapidly during the period when the child begins to sit, in the absence of treatment develops with age, becomes noticeable;
• hereditary kyphoscoliosis - transmitted by the dominant type, observed in several generations in a similar form;
• acquired (degenerative) kyphoscoliosis - develops during the period of adolescent growth of the body, at the age of 11-15, often due to improper posture, excess weight, a sedentary lifestyle, due to uneven distribution of physical activity, improper carrying of weights and sitting at the table. Also, acquired kyphoscoliosis can occur against the background of spinal injuries, muscle damage, inflammatory processes and serious deviations of the central nervous system;
• idiopathic kyphoscoliosis is a form with an unknown etiology.

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

Depending on the progression of the disease, static and progressive forms are distinguished.

Depending on the part of the spine in which the scoliotic curvature arose, kyphoscoliosis is divided into:

• thoracic - kyphoscoliosis of the thoracic spine;
• lumbar - affect the lumbar region;
• thoracolumbar - curvature in the thoracolumbar junction;
• combined - double S-shaped curvature.

Disease stages

There are four degrees of development of kyphoscoliosis.

1. Deviation in the anteroposterior direction with slight twisting (rotation) of the vertebrae. The angle of curvature of the spine is 45–55 °.
2. A noticeable twisting of the spine to the side, in the anteroposterior direction. The angle of curvature of the spine is 55–65 °.
3. Deformation of the chest, the formation of the rib hump. The angle of curvature of the spine is 65–75 °.
4. Visible deformation of the entire chest and spinal column and pelvic bones, the formation of the anterior and posterior humps. The angle of curvature of the spine is more than 75 °.

Kyphoscoliosis of III and IV degrees can be corrected only by surgery.

Symptoms

Kyphoscoliosis leads to a violation of the mobility of the chest, which becomes the cause of the development of pulmonary failure. Prolonged hypoxemia leads to disruption of the right ventricle of the heart, the so-called kyphoscoliotic (pulmonary) heart develops.

Typical manifestations of thoracic kyphoscoliosis:

• narrowing of the chest;
• wide spreading of the ribs (widening of the intercostal spaces on the side opposite to the lateral curvature);
• slouch;
• tilting the upper body and shoulders forward and downward;
• different levels of the right and left shoulder, as well as the shoulder blades;
• intense pain in the back, neck, chest.

Local signs are accompanied by general symptoms:

• intense headaches, dizziness;
• manifestations of pulmonary hypertension (shortness of breath, breathing disorders during physical exertion);
• fatigue;
• heartburn;
• change in tendon reflexes;
• feeling of weakness in the limbs;
• decreased sensitivity;
• weakness of the abdominal muscles;
• dysfunctions of the respiratory, cardiovascular system, organs of the gastrointestinal tract;
• decreased immunity.

Diagnostics

When examining the patient, the external signs of the disease, the presence of curvature and the degree of spinal deformity are clearly determined.

Additionally, laboratory tests are prescribed - a general analysis of blood, urine, determination of the level of hormones in the blood.

To clarify the diagnosis, instrumental diagnostic techniques are used:

• X-ray of the spinal column in several projections, with stretching of the vertebrae;
• computed tomography of the spine;
• magnetic resonance imaging of the thoracic spine;
• spine myelogram;
• ultrasound diagnostics.

Treatment of kyphoscoliosis

Conservative treatment can be effective only for the initial forms of kyphoscoliosis. Such therapy cannot correct the spinal deformity, but will stop its progression. The main method is physical therapy, which helps to strengthen the muscles of the back. The set of exercises is selected by the doctor on an individual basis, since mistakes can lead to an overload of certain parts of the musculoskeletal system and a deterioration in the patient's condition.

In addition, the following applies:

• massage - prescribed to stimulate blood circulation, relieve muscle tension;
• physiotherapy - allows you to relieve muscle spasm, improve blood circulation;
• mechanical correction of the spine - wearing orthopedic devices (rigid corrective corsets);
• drug therapy - it is prescribed only for severe pain syndrome.

In other cases, surgical treatment is indicated. Corrective surgeries are performed on the spine and chest. In the recovery period, a plaster corset is used for the fusion of the vertebrae.

Complications

Pathology is characterized by deformation of the spinal column and accompanying back pain, and changes in the shape of the chest with kyphoscoliosis of the thoracic spine can lead to the development of heart disease, shortness of breath. Failure to take measures to treat the disease can lead to neurological complications, a decrease in chest capacity, slowing of blood circulation, constant fatigue, weakness, the development of spinal cord pathologies, pulmonary hypertension. Violation of the physiological shape of the spine causes an overload of the paravertebral muscles, therefore, early development of intervertebral hernias, osteochondrosis, and myositis is possible. In turn, they can lead to compression of the spinal cord and cause impaired sensitivity, loss of reflexes, dysfunction of the pelvic organs.

The disease can affect the location of internal organs, which manifests itself in incontinence of urine, feces, numbness of the extremities, and in the case of displacement of the cervical vertebrae in severe forms of kyphoscoliosis - difficulties in eating.

Kyphoscoliosis affects the work of all internal organs and systems, therefore, patients with this pathology are susceptible to infectious diseases due to weak immunity.

Forecast

The progressive form of kyphoscoliosis in the absence of treatment eventually leads to loss of mobility of the spine, deformation of the vertebrae and intervertebral discs. With timely treatment, the prognosis for recovery is favorable.

Prevention

The main condition for the prevention of kyphoscoliosis is the need for early detection of children with impaired posture. For this purpose, regular medical examinations are carried out in educational institutions. Individual prevention of kyphoscoliosis includes regular physical activity, timely correction of posture disorders, proper organization of the workplace, maintenance of normal body weight, and balanced nutrition.

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Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!