Spinal kyphosis: causes, types and treatment of spinal curvature

29.01.2021

Kyphosis is an acquired or congenital deformity of the spine that forms a bulge. Curvature of the thoracic region within normal limits is called physiological and does not require special treatment. Kyphosis acquires its pathological form against the background of lung diseases (rickets, tuberculosis). Significant curvature is characterized by pain in the back and has neurological disorders.

Kyphosis is manifested by stooping or hunchback (in especially severe cases). The patient's shoulders protrude forward and down, causing the chest to narrow. The diaphragm changes its position, moving down, and the upper part of the body moves forward. The longer the pathology develops, the higher the risk of vertebral deformation and destruction of intervertebral cartilage. Over time, the back muscles become stretched and the muscles in the front of the abdominal cavity become deformed. As a result, the mobility of the ribs and intercostal muscles decreases, and the lungs cannot function fully. Therefore, severe forms of kyphosis are accompanied by cardiac and pulmonary pathologies.

The nature of the curvature determines its shape and has its own characteristics. Angular kyphosis is characterized by a hump-shaped formation, which causes the chest to protrude forward and the torso to become shorter. Arc-shaped kyphosis deforms the entire thoracic region in the shape of the letter C.

Causes of kyphosis

As a pathology, kyphosis develops for reasons such as:

• disturbances in the process of fetal development;
• genetic predisposition;
• spinal injuries of various etiologies;
• underdeveloped back muscles;
• compression fractures of the vertebrae due to the loss of bone tissue density;
• diseases of the spine of various nature;
• neoplasms in the spinal column.

In very rare cases, pathological kyphosis can occur after radiation therapy, which is used to treat malignant neoplasms in children.

Which doctor should I contact?

Kyphotic changes in the spine are treated by orthopedic traumatologists, as well as neurologists if the patient has neurological disorders caused by pinched nerve roots. It is important to understand that the success of therapeutic measures directly depends on the timeliness of contacting specialists. This allows you to start treatment of the disease on time, prevent its progression and the development of complications.

You need to take the choice of a doctor responsibly and entrust your health exclusively to specialists with extensive experience and a sufficient level of competence in the treatment of various pathologies of the spine associated with its curvature and poor posture.

Forecast

A large curvature of the thoracic spine affects both the health and anatomy of the spine and the organs located nearby. Due to the reduction in the size of the chest, the volume of the lungs decreases, and accordingly, the functioning of the circulatory system and its dependent systems is disrupted, since an insufficient amount of oxygen is supplied.

Pressure from the diaphragm disrupts the functioning of the abdominal organs, causing constipation. The load on the spine is redistributed, subjecting the intervertebral discs to deformation and provoking the development of osteochondrosis. Severe kyphosis can lead to compression of the spinal roots, as evidenced by symptoms such as partial or complete loss of sensation, impaired functioning of the pelvic organs and muscle weakness.

What is the danger of the disease

Any curvature of the spine, if left untreated, will lead to disruption of the functioning of internal organs and, as a consequence, of all body systems. It's also an aesthetic issue. Over time, without treatment, the curvature becomes irreversible and can only get worse over the years. As a result, the patient risks getting problems in the gastrointestinal tract, heart, genitourinary system, musculoskeletal system, etc. Common complications of kyphosis are osteochondrosis and intervertebral hernia.

Types of disease

Pathological kyphosis is varied. Its type depends on the causes of the disease:

• functional kyphosis or incorrect posture: the cause of the appearance is a weak muscle corset or an unnatural position of the back during prolonged sitting. In some cases, this type of kyphosis is associated with psychology: for example, very tall teenagers try to hide their height and slouch, just as insecure people raise their shoulders to appear more inconspicuous. Trying to compensate for the excessive backward curvature of the spine, the body begins to protrude the lumbar region inward, forward, which causes a concomitant disease - lumbar hyperlordosis.
• dorsal juvenile kyphosis (Scheuermann-Mau disease): presumably, Scheuermann-Mau disease appears as a consequence of necrosis of cartilage tissue (avascular necrosis), excessive growth of bone tissue in the vertebral bodies and multiple vertebral fractures due to osteoporosis. The causes of this type of kyphosis have been little studied, but one thing is certain - genetic predisposition plays a special role here. Scheuermann-Mau disease distorts the shape of the vertebrae, complicating the form of kyphosis. The bending angle can reach up to 75 degrees.
• congenital kyphosis: a disorder appears at the stage of development of the vertebrae in the embryo. The deformation appears as irregularly shaped segments. The curvature can develop in any direction with the apex located in any part of the spine. A disease of this form often progresses, combined with other pathologies and neurotic disorders.
• paralytic kyphosis: appears against the background of diseases associated with weakened or paralyzed back muscles. For example, with cerebral palsy, thoracic kyphosis progresses and increases its length to the lower back, acquiring scoliosis as a concomitant disease.
• post-traumatic kyphosis: fractures of the thoracic or lumbar vertebrae often cause the development of post-traumatic kyphosis. The appearance of the disease is associated with the severity of the injury, the accuracy of following the instructions of the attending physician for the rehabilitation period, and the presence of other diseases associated with disorders of bone or muscle tissue.
• degenerative kyphosis: such kyphosis is a consequence of degenerative changes in the spinal column. Degenerative changes can be either a natural process of aging of the body or a consequence of a slowly developing pathology. Therefore, older people are more likely to be affected by this type of kyphosis.

Prevention of kyphoscoliosis

The essence of preventive measures is to prevent pathological curvature of the spine. Strengthening the back muscle corset with the help of such sports as swimming, dancing, Pilates helps with this. A contrast shower tones the muscles well.

It is important to ensure the correct position of the body when working at the computer.
Warming up (at least once an hour) helps to relax the muscles. To sleep, you should purchase an orthopedic mattress. Your daily diet should include fish, dairy products, fresh vegetables and fruits.

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.

Diagnosis methods

Diagnosis is carried out by an orthopedic surgeon

in several stages:

1. A detailed examination by the doctor of the medical history, examination, and interview of the patient.
2. Palpation of the patient's spine and testing of reflexes.
3. Mandatory x-ray
   of the spine - direct and lateral images.
4. In some cases, if soft tissues are also affected, MRI
   .
5. , a computed tomography scan
   is additionally prescribed .

After a complete diagnosis, the doctor prescribes treatment.

Treatment of kyphosis

The treatment method is prescribed according to the type of disease.

Functional kyphosis is treated with exercise therapy and conservative therapy. With the help of exercises, the patient strengthens the muscle corset and learns to maintain correct posture. An orthopedic corset is not needed in such cases. A similar method is used for degenerative kyphosis.

Juvenile kyphosis usually does not bother patients until the angle of curvature increases enough to cause pain. The chest is deformed, interruptions in the heart function and difficulty breathing appear. The main treatment is conservative. It includes massage, physical and manual therapy, exercise therapy, and in special cases it is recommended to wear an orthopedic corset. If the bend is 75 degrees, surgery is prescribed.

Congenital kyphosis in 13% of cases is combined with other pathologies of the spine, accompanied by impaired development of organs, systems and neurological disorders. Conservative treatment for this disease is ineffective, so surgery is performed in childhood so that the spine can be stabilized by growing bone tissue, thereby preventing deformation in the future.

With paralytic kyphosis, the disease tends to develop, which is why conservative therapy is delayed for a long time. If there is no positive result and the patient’s condition worsens, surgery is prescribed.

Post-traumatic kyphosis is a type of kyphosis that is treated primarily surgically because the disease affects the nerve endings. If the patient has contraindications for surgery, then an intensive course of conservative therapy using an orthopedic corset is prescribed.

Symptoms

The fundamental factor is the degree of curvature.

• Stage 1 kyphosis is characterized by fatigue and mild muscle pain, mainly at the end of the day. You can also observe poor posture and stooping.
• Kyphosis 2 degrees, when the kyphosis worsens and is complemented by compensatory lordosis, pain and stoop increase, the head and shoulders drop down.
• Kyphosis of the 3rd degree is accompanied by limited mobility of the spine, disturbances in the functioning of internal organs appear as a result of their compression by the deformed chest.

Where does this lead?

In recent years, the health of our children has deteriorated significantly and will continue to deteriorate. These are not empty words... So, your child went to school (he sits there), then he came home, did his homework, and sat again. Then you need to play on a computer, tablet, console - he sits again, then institute, college, technical school - he sits again. We sit in the car, we sit at work, we sit in front of the TV at home, we sit at the computer. Horror - all life is just sitting. Static (immobile) tension of the back muscles leads to venous stagnation - the nutrition of the discs is disrupted, incorrect posture is formed, osteochondrosis becomes younger and younger, disc herniations multiply like cockroaches. And spinal problems today (and in the near future) occupy a leading place and affect 95% of children aged 10 to 18 years.

Curvature of the spinal column entails muscle deformation. The spine begins to resemble a bowstring - on one side the muscles are overstretched and weakened, on the other they are spasmed, tense and visually shortened. The muscles become “clogged”, painful, on one side of the back, over time, a muscle hump begins to grow, and the connective tissue degenerates.

Mechanical deformation of the discs leads to compression of the nerve endings leading to the internal organs, thus S-shaped thoracic scoliosis (or thoracic kyphosis ) - deformation of the spine at the level of the shoulder blades - 4-5 thoracic vertebrae - leads over time to cardiovascular failure. This is a rapid heartbeat - tachycardia, pain in the heart area, arrhythmias, jumps in blood pressure.

And similar symptoms often appear in both adults and children. Thoracic scoliosis is dangerous due to the gradual development of pulmonary problems - bronchitis, bronchial asthma. The urinary system - kidneys, bladder - suffers. The gastrointestinal tract also makes itself felt - the functioning of the stomach and intestines is disrupted. It all started with a seemingly innocent scoliosis of the thoracic spine.