Spinal kyphosis: causes, types and treatment of spinal curvature

Causes and mechanism of poor posture

congenital acquired causes of poor posture ,

• underdevelopment or asymmetrical development of body muscles that should hold the spine in the correct position;
• inconsistency of furniture with the height of the student, insufficient lighting of the workplace;
• uncomfortable clothing that compresses the chest;
• staying in one position for a long time - sitting at a table with your head bowed, improper sitting on a chair;
• passive lifestyle;
• incorrect selection of mattress and pillow for sleeping;
• lack of physical activity;
• constantly wearing heels;
• an incorrectly selected backpack or satchel for a child;
• flat feet, joint diseases.

in adulthood, back pain , herniated discs

Diagnosis of kyphosis

Kyphosis is diagnosed and treated by a traumatologist or orthopedist. An initial consultation allows you to collect a clinical picture from the patient’s words and a visual examination by a doctor. The doctor is interested in the nature of the pain and whether there are neurological disorders. To do this, palpation of the affected part of the spine is used, muscle strength is measured, deep reflexes are examined to determine the sensitivity of the nerves, and the heart and lungs are listened to.

For kyphosis, radiography is included in the list of mandatory studies. Pictures of the spine are taken in different projections.

An additional study in all cases of kyphosis is MRI. It is needed to examine soft tissues at the time of their damage. CT scan is prescribed if pathological changes in bone tissue are suspected.

Musculoskeletal system

Incorrect posture is the most common cause of pain in the lower back, neck and thoracic region. Tilt of the head forward and slightly rounded shoulders increase the load on the cervical and thoracic regions several times.

On average, an adult's head weighs 4-5 kg, which means that the same weight is constantly acting on your spine, provided that your head is not tilted. By tilting your head, you increase the load on the cervical and thoracic spine .

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The worst thing is that most people keep their head at a 60 degree angle while reading text on their mobile . It has also been proven that a strong forward head tilt reduces lung capacity by 30%, and this significantly affects the body's ability to perform cellular respiration. In such a situation, oxygen is chronically insufficient, and it is delivered only to the most basic priority organs.

Spinal cord

The spinal cord is one of the parts of the central nervous system. It is a long, delicate cylindrical cord, slightly flattened from front to back, from which the nerve roots branch. It is the spinal cord that is responsible for transmitting bioelectric impulses from the brain to every organ and muscle and vice versa. It is responsible for the functioning of the sense organs, contraction when the bladder is filled, relaxation of the sphincters of the rectum and urethra, regulation of the functioning of the heart muscle, lungs, etc.

The spinal cord is located inside the spinal canal, and its length in an adult is 45 cm in men and 41-42 cm in women. Moreover, the weight of such an anatomical structure, which is so important for the human body, does not exceed 34-38 g. Thus, the length of the spinal cord is less than the length of the spinal canal. It starts from the medulla oblongata, which is the lower part of the brain, and thins out at the level of 1 lumbar vertebra (L1), forming the conus medullaris. The so-called filum terminale departs from it, the lower part of which consists of the spinal membranes and is ultimately attached to the 2nd coccygeal vertebra.

In men, the apex of the conical point of the spinal cord is localized on the border of the lower edge of L1, and in women - in the middle of L2. From this moment on, the spinal canal is occupied by the lumbosacral roots, extending from the last segments of the spinal cord, which forms a large nerve formation - the cauda equina. Its constituent nerve roots emerge at an angle of 45° from the corresponding intervertebral foramina.

In newborn children, the spinal cord ends at the level of L3, but by the age of 3, its cone is already at the same level as in adults.

The spinal cord is divided by longitudinal grooves into two halves: anterior and posterior. Its central part is formed by gray matter, and the outer layers are formed by white matter. In the central part of the spinal cord there is a canal that contains cerebrospinal fluid. It communicates with the fourth ventricle of the brain. In adults, this canal is closed in some parts or along the entire length of the spinal cord. Gray matter is formed by the bodies of neurons, i.e., nerve cells, and in cross section resembles a butterfly in shape. As a result, it contains:

• The anterior horns contain motor neurons, also called motoneurons. Like any other neurons, they have long processes (axons) and short branches (dendrites). The axons of motor neurons transmit impulses to the skeletal muscles of the arms, legs and torso, provoking their contraction.
• Posterior horns - the bodies of interneurons are located here, which connect sensory neurons with motor neurons, and also take part in the transmission of information to other parts of the central nervous system.
• Lateral horns - neurons that create the centers of the sympathetic nervous system are localized in them.

On average, the diameter of the spinal cord is 10 mm, but in the region of the cervical and lumbar spine it increases. In these places, so-called thickenings of the spinal cord are formed, which is explained by the influence of the functions of the arms and legs. Therefore, in the cervical spine its transverse size is 10-14 mm, in the thoracic spine - 10-11 mm, and in the lumbar spine - 12-15 mm.

The spinal cord is bathed in cerebrospinal fluid, or cerebrospinal fluid. It is designed to act as a shock absorber and protect it from various damages. In this case, the cerebrospinal fluid is the most filtered blood, devoid of red blood cells, but saturated with proteins and electrolytes, the vast majority of which are sodium and chlorine. Thanks to this, it is completely transparent. Liquor is formed in the ventricles of the brain at a rate of approximately 0.5 liters per day, although on average its volume in the canal does not exceed 130-150 ml. Therefore, even with significant losses of cerebrospinal fluid, its losses are quickly compensated by the body. A small part of the cerebrospinal fluid is absorbed by the blood and lymphatic vessels of the spinal cord.

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Spinal cord membranes

The spinal cord is surrounded by 3 membranes: the hard outer membrane, the arachnoid membrane, separated from the first by the subdural space, and the internal one, called the pia mater. The latter is adjacent directly to the spinal cord and is separated from the membrane occupying the middle position by the subarachnoid space. Each of the spinal membranes has its own structural features and performs specific functions.

Thus, the hard shell is a kind of connective tissue case for this sensitive and important nervous structure, densely intertwined with blood vessels and nerves. It consists of collagen fibers and has 2 layers, the outer one fits tightly to the bone structures of the spine and, in fact, forms the periosteum, and the inner one forms the dural sac of the spinal cord. The dura mater is additionally strengthened by multiple bundles of connective tissue, which connect it to the posterior longitudinal ligament, and in the lower parts of the spine they form the filum terminale (filum terminale of the spinal cord), which is ultimately attached to the periosteum of the coccyx. The hard shell has different thickness in different areas, which ranges from 0.5 to 2 mm. It reliably protects the spinal cord from most external influences and runs from the foramen magnum down to 2-3 sacral vertebrae, i.e., it covers the delicate spinal cord along its entire length.

In addition, this shell has cone-shaped protrusions. They are designed to form a protective layer for the nerve roots extending at the level of all vertebrae, and therefore exit with them into the intervertebral foramina.

The dura mater is delimited from the wall of the spinal canal by the epidural space. It contains fatty tissue, spinal nerves and numerous blood vessels responsible for the blood supply to the vertebrae and spinal cord.

The subdural space mentioned above separates the dura mater and the arachnoid membrane of the spinal cord. Essentially, it is a narrow gap filled with thin bundles of connective tissue fibers. In this case, the subdural space ends blindly at the S2 level, but has a free connection with a similar space inside the cranium.

The arachnoid membrane is a delicate, transparent anatomical structure formed by multiple trabeculae (cords), which does not have a rigid fixation system with the dura spinal membrane. They are connected to each other only at the intervertebral foramina.

The arachnoid membrane is separated from the soft membrane by a subarachnoid (subarachnoid) space in which cerebrospinal fluid circulates, and also connective tissue cords pass that unite these membranes with each other. The subarachnoid space communicates with the fourth ventricle of the brain, which ensures continuous circulation of cerebrospinal fluid.

The third membrane of the spinal cord is located in the closest proximity to it and has many blood vessels that provide blood delivery to the spinal cord. It is connected to the arachnoid membrane by a significant number of connective tissue bundles.

Body position of a newborn baby: vertical or horizontal?

What is better: to carry your baby in your arms, holding him in an upright position, or to carry him in a stroller, where he lies on his back? The first is preferable, since in the latter case the back remains in the same position in the shape of the letter C and the spine does not develop, muscle tone decreases.

Of course, you can push your baby in a stroller to the desired location, but in reality, many parents only hold their baby for a couple of hours a day, and the rest of the time he lies on his back in a crib or in his “personal vehicle.”

Here are other benefits of standing upright for babies during the day.

• The risk of developing ear infections is reduced: they appear due to the fact that when the baby is most often in a horizontal position, mucus is not removed in the nasopharynx and enters the middle ear, causing inflammation and otitis media.
• The vestibular apparatus develops: the baby moves with the parent.
• The child feels safe.
• He learns faster because he sees more objects and hears more sounds.

It is harmful for babies to remain in a car seat or carrier for more than two hours: their spine needs to develop, and this does not happen in the letter C position.

When does the normal curvature of the spinal column form?

Many people ask the question: “How many curves does the human spine have?” There are 4 types of physiological curvature of the spine. When a person is born, he has only a single kyphosis in the sacral region. During the development of a child, three more physiological curves of the spine are formed:

• from 2 to 3 months, the baby learns to hold its head by raising and lowering it. Thus, cervical lordosis begins to form;
• by 11–12 months, when the child sits well and can stand independently, kyphosis of the thoracic region forms;
• starting from the age of one, a deflection of the lumbar region appears with a convexity forward. At about 13 months, most children begin to walk and move actively, resulting in a strong corset of skeletal muscles. Lumbar lordosis is formed.

To avoid pathological curvature of the spinal column in a person, it is necessary not to rush things, that is, do not try to sit the baby up or put him on his feet before the due date. The natural curves of the spinal column stop forming by the age of seven. It is very important to monitor the correct posture of children in order to prevent the development of serious diseases such as scoliosis, pathological lordosis and dysplasia.

Interestingly, while still in the womb, the child may begin to develop abnormal curves in the spine, leading to deformation of the vertebrae. Why might this happen? Most often this is due to heredity or vitamin D deficiency. But despite this, early detection of pathology helps prevent the formation of serious and irreversible consequences.

Physiological curves of the human spinal column

Incorrect formation of bends

Sometimes, for some reason, pathological curves of the body may develop. Then lordosis and kyphosis are perceived as serious diseases of the musculoskeletal system and require immediate treatment.

Pathological lordosis

This is the name of a pathology in which the spinal column is convex forward. It can develop at any age due to acquired or congenital anomalies of the vertebrae, hip joints, spinal, femoral and gluteal muscles, oncological intervertebral neoplasms, spinal injuries, certain diseases (poliomyelitis), the period of gestation. In the latter situation, lordosis is temporary and will completely disappear when the child is born.

Lumbar hyperlordosis

Other predisposing factors are obesity with a large amount of fat in the abdominal area, very rapid growth of the child and poor posture. With all these diseases and pathologies, the center of gravity shifts, as a result of which a person begins to bend in order to maintain balance.

Symptoms of pathological lordosis will include changes in posture, increased fatigue, moderate pain in the cervical or lumbar region, which intensifies after physical activity.

In addition, there is stiffness in some movements. If lordosis has a very pronounced manifestation, then as a result the internal organs begin to suffer: diseases of the heart, lungs, stomach, intestines and kidneys develop, resulting from compression or incorrect location.

Pathological kyphosis

Kyphosis is a condition in which the column of vertebrae points backward in some segments, causing deformation of the back. It is diagnosed in both children and adults, mainly in females. The reason for the incorrect formation of bends is:

• growth inhibition in adolescents as a result of vertebral circulatory disorders;
• inflammatory process;
• infections;
• spinal injuries;
• diseases of the endocrine system (hyperfunction of the parathyroid gland);
• polio; long-term therapy with glucocorticosteroids;
• oncological neoplasms;
• tuberculosis.

Pathological kyphosis develops gradually

As the angle of bending increases, the following symptoms may appear: pain at the upper border of the bend, worsening after playing sports or improper body position, back deformation, curvature of posture, increased fatigue. The tendons become very tight, which explains the difficulty of straightening the legs at the knees. It is impossible to straighten the spine when lying on your back. Cramps of the lower extremities are very rarely observed.

Scoliosis

Scoliosis is a pathological condition in which curvature of the spinal column occurs, first on the sides, and then in other planes. In people who do not undergo treatment, the spinal column may eventually curl around itself. Most often, scoliosis can be found in children during adolescence, but cases have also been recorded in adults. The impetus for curvature of the spine is injuries, stooping and incorrect posture during sedentary work.

By nature, there are 4 types of scoliosis: C-shaped, S-shaped, Z-shaped and kyphoscoliotic. Based on some symptoms, you can suspect the presence of scoliosis and begin to take measures, these are:

• pain that increases with physical activity and incorrect body position not only in the back, but also in the legs and pelvic area;
• difficulty turning the head and neck;
• fast fatiguability;
• the shoulders are at different levels (one higher than the other);
• asymmetrical arrangement of the shoulder blades (the shoulder blade located closer to the spinal column has a protruding angle);
• when placing the arms along the body, there is a different distance between the arm and the body;
• when the body is tilted forward, the curvature of the spine is visible;
• the pelvis is skewed in the opposite direction;
• weakness of the back muscles.

If you do not take measures to combat scoliosis, then more serious complications may appear: disruption of the normal functioning of internal organs, their deformation, disorders in the functioning of the heart, lungs, and nervous system. Chronic diseases develop: gastritis, duodenitis, peptic ulcer of the stomach and duodenum, constipation, numbness of the upper and lower extremities appears, they can also “shrink out”. Cerebral circulation is disrupted and a kyphotic hump appears.

Measures to prevent the development of scoliosis must be applied from childhood

Three sad key points

Treatment methods once approved by the Ministry of Health are quite outdated in our time. We will proceed from what we have with this problem.

The first is the deformation of the discs - our shock absorbers, thanks to which we can bend and unbend.

The second is compression of the nerve endings coming from the spinal column to the internal organs.

Third - deformation of the muscular-ligamentous corset , resulting from a misalignment of the spine.

The spinal column (essentially) is cubes of vertebrae placed on top of each other, like a children's pyramid. If we remove all the muscles and ligaments at once, then our cube-vertebrae will collapse, since the spine itself, the skeleton, will not stay upright without a muscular-ligamentous corset. Spinal problems in humanity began from the moment we got up from all fours, as the vertical load on the spinal column increased. We have an alternative - to return to https://www.youtube.com/embed/Ijbh6BscW1s the starting position, to our smaller brothers - our four-legged friends, since none of the representatives of terrestrial animals have such a variety of diseases with the spine as in humans fauna. This means that first of all it is necessary to restore the muscles and ligaments of the back. In parallel with this, influence the deformed disc, restore its nutrition and structure. Gradually, the vertebrae return to their anatomical place, naturally freeing the nerve endings going to the internal organs (heart, lungs, liver, etc.)

Necessary measures for correct posture

All people with pathological curvature of the spinal column must be monitored by an orthopedist-traumatologist. In turn, the doctor must prescribe all possible procedures aimed at eliminating the diseases: massage, physical therapy, orthopedic supplies, manuals, manual therapy, physiotherapy, etc. are prescribed. In severe cases, surgical treatment is indicated.

As measures aimed against the development or progression of scoliosis, kyphosis and lordosis, it is necessary to carry out comprehensive measures:

• sleep on a hard bed on an adjustable mattress, in a position on your back or stomach;
• wearing orthopedic shoes or inserts in the form of insoles with an anatomical structure;
• physical labor: swimming, athletics, tourism and others;
• strict adherence to the daily routine (getting up and going to bed at the same time, eating);
• giving up bad habits (smoking, alcohol abuse, drug addiction). Other bad habits include avoiding certain incorrect positions, such as sitting cross-legged or standing on one leg;
• self-monitoring of correct posture during sedentary work, at a school desk, at home on a chair, etc.;
• wearing special equipment, corsets and other accessories in case of violation of the normal curvature of the spinal column to fix it;
• uniform distribution of the load on the spine when carrying bags, backpacks, briefcases.

Parents need to monitor the health of their children at any age. It is from adolescence that pathological curves of the spine most often form. If you do not notice this in time, the diseases will progress, bringing a lot of discomfort and health problems.

What role do the curves of the spine play?

Very often people are interested in what role the curves of the spinal column play. Their main task is depreciation, i.e. the correct distribution of loads on the spine. In addition, it eliminates lateral loads, which can cause displacement of the vertebrae and intervertebral discs. Due to physiological curvature, protection from excessive shock to internal organs, the spinal cord and brain occurs, as well as stability and mobility of the body.

Important! If the function of the spinal column is impaired and the angle of bending increases or decreases, then a diagnosis of pathological lordosis or kyphosis is made.