Scoliosis in children and adults: degrees and treatment features

With scoliosis, the spine deviates to the side, and the displaced vertebrae change their shape. The problem is not limited to an aesthetic defect and can have serious consequences for the entire body.

It is very important to identify the deformity in time and begin treatment in childhood, since the spinal column of an adult is difficult to correct.

Curvature of the spine in children causes pathological changes in itself and surrounding tissues. These changes lead to rotation (torsion) of the vertebral bodies and disruption of the motor stereotype, and also negatively affect the condition of the intracavitary organs.

Scoliosis is widespread among children and is found in approximately 7% of children, more often girls. The progression of the disease can lead to displacement, compression and deterioration of the functioning of the thoracic and pelvic organs.

Causes of scoliosis in adolescents

This disease can be of two types. Namely:

1. Congenital.
2. Acquired.

Treatment of scoliosis in children and adolescents in the first case will be needed due to the fact that there was an abnormal formation of the child’s body in the womb. It is impossible to prevent this state of affairs. Acquired scoliosis is provoked by a number of factors. These include:

• incorrect posture;
• insufficiently strong muscle corset;
• uneven development of bones and muscles;
• carrying heavy weights on one shoulder;
• insufficient physical activity;
• vegetative-vascular dystonia;
• injuries received.

Treatment of grade 2 or 3 scoliosis in adolescents will depend on the reasons that led to this condition.

Causes

In the vast majority of cases, the cause remains unknown, and scoliosis is considered idiopathic. Increased risk factors are:

• asthenia;
• sedentary lifestyle;
• serious loads on the spine, exceeding its capabilities;
• bad posture.

The curvature is congenital, when a child is born with various anomalies of the vertebrae, spinous processes and ribs. They can be underdeveloped (hemivertebrae) and fuse together, which is more often observed in the lumbar region and is detected in the form of lumbarization or sacralization.

Acquired scoliosis often occurs due to traumatic injuries, including congenital hip dislocations, different leg lengths, and problems with flexion and extension of large joints of the lower extremities.

Curvature of the spine can be of neurogenic, metabolic, rheumatic origin and develop against the background of diseases such as:

• poliomyelitis, Friedreich's ataxia, cerebral palsy, syringomyelia;
• myopathy, muscle dystrophy;
• rickets, cystinosis, bone formation disorders, Hunter syndrome;
• rheumatoid arthritis;
• osteochondrosis, neurofibromatosis.

Types of scoliosis in adolescents

Scoliosis that occurs in children during adolescence (10–17 years) is called juvenile scoliosis. It differs in the number of arcs of curvature:

• C-shaped - one arc of curvature, this is the most common type of disease;
• S-shaped - the spine is curved in two sections in two directions at once;
• Z-shaped – this type of scoliosis is the most difficult to treat.

It also happens (extremely rarely) that the vertebral curve is accompanied by a curvature of the sternum and a hump on the ribs - kyphoscoliotic scoliosis. Scoliosis also occurs in adolescents from the first stage and progresses to the fourth. On the first, the curvature is 5–10 degrees, on the second – 11–25 degrees, on the third – 26–50 degrees, on the fourth – more than 50 degrees.

How to choose a roller

You can buy a ready-made roller (sold in health departments). If you have not done Fukutsuji gymnastics before, choose models with a small diameter and not too hard. Have you tried therapeutic lying down yet? You can afford a thicker and harder roller.

However, you can “prepare” the roller yourself: roll a wide bath towel into a tight roll and secure it with tape at the edges. You should end up with a roller approximately 40 cm long. Adjust the diameter yourself: it is advisable for beginners to take rollers 7-8 cm wide, for more experienced “loungers” - 9-12 cm. Over time, it makes sense to “change” to a purchased roller with a denser structure, to gradually increase the degree of spinal traction.

Symptoms

At the very beginning, immediately after its appearance, scoliosis does not show itself at all; characteristic symptoms appear only from the second stage. She is like this:

• the child's head is constantly lowered;
• the shoulders are pulled together, the child is slouched;
• the teenager does not place his shoulders at the same level.

At the third stage, the spine is clearly curved, discomfort and back pain appear, and the head begins to hurt. In addition, parents seriously think about how to treat grade 2 or 3 scoliosis in a teenager when their child develops shortness of breath and the heart begins to beat faster.

Contraindications

Therapeutic gymnastics in some cases may be contraindicated in whole or in part, until the risk factors for complications are eliminated. Some patients can perform exercises only in a physical therapy room, under the supervision of a specialist. All this is determined by the attending physician during the examination, but it is impossible to independently assess the health risks.

Some patients should exercise under the supervision of a physical therapy doctor

The main contraindications for prescribing exercise therapy are:

• scoliosis 4 degrees;
• accelerated progression of the disease;
• serious dysfunction of the cardiac or respiratory system;
• high intracranial pressure.

Scoliosis 4 degrees

Reasons for temporarily stopping classes:

• exacerbation of chronic diseases;
• infectious and colds accompanied by high fever;
• postoperative period;
• increased pain in the spine after physical activity.

If you experience severe pain, stop training temporarily.

Exercises should not be performed until the condition has stabilized, so as not to provoke deterioration. If pain or discomfort is related to your back, be sure to tell your doctor and do not try to solve the problem on your own. The spine contains many nerve endings that are often pinched due to deformation of the vertebrae. When examined in a clinic, it is easy to identify problem areas and eliminate the cause of pain, but this is unlikely to be done at home. And the more neglected the condition, the more difficult it will be to cope with it.

Hypertensive patients, heart patients, and patients with chronic gastrointestinal diseases should practice under the supervision of a doctor. The same applies to pregnant women over 3 months of age: at home it is difficult to control the distribution of the load, so it is better to practice in a physical therapy room with an experienced specialist.

How to diagnose scoliosis in a teenager

It is important not only to consult a doctor in a timely manner if there are visible problems, but also to be attentive to the state of your child’s health. In order to begin timely treatment of grade 1 and 2 scoliosis in a child, it is worth learning some methods for diagnosing the pathology. Namely:

1. Ask the child to lie on his stomach and examine his spine: if you see a curvature that does not go away with a change in position, most likely you have scoliosis.
2. Ask the child to stand with his back to you, stretch out his arms and bend over: if you notice asymmetry, it makes sense to see a neurologist
   .

In order to confirm or refute the diagnosis of scoliosis, the doctor prescribes an x-ray of the spinal column in an upright position, using the Cobb technique. The doctor will determine the presence of scoliosis and its degree - 1, 2 or 3, and tell you how to treat this pathology in a teenager.

Surgery

Surgery for scoliosis is indicated for approximately 10% of all patients. It is carried out when:

• severe pain and limitation of mobility that cannot be eliminated through conservative therapy;
• deformities with a curvature angle of more than 40–45° (if it exceeds 50–60°, surgical intervention is required, especially in children during the period of active growth);
• congenital anomalies that provoked the development of the disease - synostosis, the presence of additional hemivertebrae;
• the occurrence of cardiac or respiratory failure;
• threat of damage to the spinal cord, its blood vessels and nerves.

Thus, surgery to correct scoliosis is mainly performed at stages 3 or 4 of its development. It is also necessary to eliminate congenital anomalies. In other cases, our doctors are able to conservatively treat the symptoms of spinal scoliosis and obtain excellent results.

For congenital defects that provoke rapid progression of the disease, surgery is recommended for grade 2 scoliosis in children. This is a preventative measure. Treatment of the cause of scoliosis in children eliminates the prerequisites for repeated curvature of the spine. As a result, it is possible to avoid disruption of the functioning of internal organs and reduce the likelihood of developing other complications.

Types and features of operations

All types of surgical treatment of the disease used today involve the installation of special fixation systems on the spine. Most of them were first tested in the last century and are still successfully used to eliminate grade 3 and 4 deformities.

Installation of fixing structures is carried out under general anesthesia and takes about 3–4 hours. They are metal rods or cylinders that are secured to the spine using locking pedicle screws.

Each operation is associated with certain risks, since more than 20 fixing elements are required to be installed. The introduction of each of them can damage nerve fibers and lead to serious consequences, including disability. Therefore, surgical treatment of scoliosis should be trusted only to highly professional spinal surgeons with extensive experience in this field.

When operating on children, preference is given to movable fixators (growing structures). They do not interfere with the growth of the spine and ensure its correct formation. For patients over 14 years of age, fixed structures are usually installed.

Simultaneously with open surgery to correct vertebral deformity, surgical treatment of stenosis, intervertebral hernias, etc. can be performed. Surgical treatment does not involve repeated operations to remove metal structures. Therefore, it is worth being scrupulous in the choice of the method of its implementation and the quality of the implanted fixators. When you contact the SL Clinic, you will receive the maximum amount of information about various methods for correcting spinal curvature and recommendations from highly qualified spinal surgeons.

We treat scoliosis using high-quality materials. The high level of professionalism of surgeons ensures a low risk of complications and accidental damage to nerve endings. By contacting us, you protect yourself from receiving low-quality services and the possibility of breakdown of the installed structure.

Minimally invasive surgical treatment methods

Reducing operational risks and increasing the efficiency of procedures are the main goals of scientific research in the field of spinal surgery. The latest advances in medicine in this area are the creation of ApiFix technology and the installation of magnetic rods. An additional advantage of minimally invasive techniques is the absence of large postoperative scars along the entire length of the spine.

The ApiFix technique was developed in Israel and is the optimal solution to the problem of scoliosis for children and adolescents. Its essence is the implantation of a heavy-duty mechanism with very compact dimensions through a tiny incision in soft tissue. Its installation requires only 2 screws, which significantly reduces intraoperative risks.

It is equipped with a pressure intensity regulation system. Thanks to this, spinal surgeons have the opportunity not to radically and simultaneously change the configuration of the spine, but to gradually bring it to the desired parameters. Correction of the degree of pressure is carried out on an outpatient basis using a special needle. As a result, the patient does not experience severe pain, characteristic of the recovery period after open surgery, and easily tolerates the treatment. To achieve significant results, 3–5 months are enough, and the operation itself takes no more than an hour.

The method of surgical treatment of scoliotic deformity using magnetic rods, developed by Irish doctors, came into use in spinal surgery even later. It involves the introduction of small rods into the spine, the position of which is changed as the normal position of the spinal column is restored using a special remote control.

The procedure is also characterized by a low degree of invasiveness and high effectiveness. Like the installation of the ApiFix system, it does not cause traumatic shock and allows you to avoid postoperative pain, prolonged wearing of a corset and other inevitable factors of rehabilitation after classical operations.

After minimally invasive interventions, patients can return to their daily lifestyle almost immediately. Restrictions are imposed only on heavy physical labor and the duration of sitting.

Treatment of scoliosis in adolescents

The method of treatment is determined by the doctor depending on the degree of development of the disease, as well as the general health of the child. It often happens that juvenile scoliosis is already very advanced and has managed to provoke a lot of complications, so treatment is strictly individual.

Exercise therapy and gymnastics

If you are thinking about how to correct scoliosis in a teenage child, gymnastics will be very useful in this case. The following exercises are used:

• “swallow” - in a position on your stomach, you should raise your arms and legs up and lower them back;
• “scissors” - lying on your back, slightly raise your legs and arms and swing them, crossing and spreading your limbs;
• “bicycle” – raise your legs up on your back and imitate pedaling;
• walking on tiptoes with arms raised up.

These exercises will help you get rid of the disease over time.

Massage

Treatment of spinal scoliosis in adolescents

This also includes a massage that improves blood circulation in the back muscles. Such influences will allow you to quickly get rid of the curvature of the spinal column.

Surgery

Gymnastics and exercises will be useful for scoliosis of 1-2 degrees in a teenager, but at stages 3 or 4 the child’s health may be unsatisfactory. Surgical intervention is necessary if the disease is accompanied by complications, very severe pain, neurological symptoms, shortness of breath, heart failure, etc.

Posture correctors

Treatment of stages 2 and 3 is impossible without the use of corsets. They will help straighten the teenager’s posture, while reducing the load on the spinal column. If a doctor promptly prescribes a corset for a teenager with scoliosis, the pathology can be completely eliminated.

Diagnostics

First, a physical examination. The doctor looks at the level of the shoulders, shoulder blades, and pelvic bones, paying attention to the presence of a rib hump and asymmetry of skin folds on the back.

The angle of curvature is measured with a scoliometer: a deviation greater than 5–7° is an indication for an x-ray. Pictures are taken in standing and lying positions, and the spinal stability index is assessed based on the results.

If it is necessary to detail the condition of the tissues, MRI, CT, myelography, and optical tomography (without radiation exposure) may be prescribed. A mandatory condition of the examination is photographing the child from different positions, which is repeated during treatment to observe the dynamics.

Important ! Additional examination may include ultrasound of the abdominal organs, electrocardiogram, etc.

Varieties

The pathology is classified according to the time of occurrence, localization of the arc curve, flow speed and side of the apex of the curvature. According to the first classification, scoliosis has 3 types:

• infantile, diagnosed in the first 3 years of a child’s life;
• juvenile, developing from 4 to 6 years;
• adolescent, which manifests itself between the ages of 10 and 14.

According to the location of the arc curve, it can be:

• cervicothoracic;
• chest;
• thoracolumbar;
• lumbar;
• lumbosacral.

According to the rate of progression, the deformation is divided into progressive and stable - non-progressive. The apex of the curvature can be directed to the left or right side; on this basis, scoliosis is classified into left- and right-sided, respectively.

A set of exercises for the spine using a roller

Orthopedic rollers of suitable length and width can be purchased at pharmacies. The product can be made of compress cotton wool, foam rubber, waffle towel. A specialist will tell you the right option, so it is better to clarify this issue with your doctor. Based on the research, the doctor will be able to select the necessary roller.

What is this corrective product used for?

Pain caused by osteochondrosis in the lower back can bother not only older people, but also young people. The disease can reduce the quality of life, and a person will require a special recovery package. Often, to relieve symptoms, people with lumbar osteochondrosis

It is recommended to use a roller while sleeping. It will provide the patient's spine with the necessary support when he sleeps. The length of such a roller is approximately 700mm.

The thickness of the product is calculated as follows: it is necessary to measure the distance between the body and the mattress. The gap that remains between your neck or lower back when in contact with the sailor is exactly what the roller should fill. Therefore it should not be too big or small.

For severe lower back pain, the product should be placed under three places at once: back, knees, shins. To slightly relax the lumbar area, place your lower limbs 8-10mm above your head.

By placing a cushion under your neck, you can ensure:

• comfortable, sound sleep;
• getting rid of headaches;
• prevention of spinal curvature;
• stimulation of blood circulation in the brain.

If your back hurts in your lower back

, a roller will be needed to relax the muscles in this area and relieve tension. The mobility of the vertebrae is restored, blood flow improves.

Using an orthopedic product should be comfortable. If any discomfort or pain occurs, it means that the roller is being used or selected incorrectly. You should stop using it, or find a more suitable one.

Why do you need exercise?

If there is osteochondrosis of the spine in one of its parts, it is necessary to select a special set of exercises that will help relieve a person of pain and unpleasant accompanying symptoms, manifested by dizziness, pain of varying intensity and numbness. In this way, it will also be possible to stimulate blood circulation in the brain.

Taking into account the degree of development of the disease and the characteristics of the patient’s body, the doctor will be able to select exercises that will not negatively affect the patient’s condition, but, on the contrary, will help him get rid of the unpleasant symptoms of osteochondrosis. These exercises should be performed on a regular basis.

A set of exercises with an orthopedic roller

This complex is simple but effective.

1. This exercise will help the muscles surrounding the spine to relax, thereby increasing blood flow, and the intervertebral discs will receive more nutrition (oxygen and nutrients). First you need to take a lying position; any horizontal surface will do for this. Place a cushion under your neck so that your head hangs slightly from it. After this, make rotational movements with your head from one side to the other for two minutes.
2. For the next exercise you will need to sit on a chair. Tilt your head slightly. Relax your neck muscles. Look forward and tilt your head gradually down.
3. Now tilt your head slightly forward. Move it from side to side, from one shoulder to the other.
4. Keep your head straight and look forward. Make rotational movements around the axis with it.

Experts recommend performing these exercises every day; it will take about five minutes, but the beneficial effect will be noticeable. Important: all movements should be slow, gradual, no need to rush.

Exercises with a roller for the lumbar region

And in this case, an orthopedic product will be useful. If you can’t buy it at the pharmacy, you can make it yourself. Take a towel, preferably cotton, and roll it up. The resulting roller must be secured so that it does not unfold. A rope or elastic band is suitable for this. But before you start using, make sure that the product fits your body parameters and will be comfortable.

To perform the exercises, sit on a hard horizontal surface; you can also use a gymnastic mat.

1. Sit on the floor and then place an orthopedic product under your back. Carefully lower yourself onto it. How to understand that it is located correctly: draw a line with your finger from the navel to the bolster, the latter should be exactly at this level.
2. Spread your legs to the sides, but your big toes should touch each other, your heels should not. If this position is difficult to maintain, you can use an elastic band to secure your big toes.
3. Raise your hands behind your head. The little fingers should be fastened together. Maintain this position as much as possible, preferably 3-7 minutes. Each time you do this exercise, the duration can be increased. As a result, the spine will straighten and elongate.
4. At the end, when you have finished studying, you need to rest for some time without moving. There is no need to stand up abruptly, wave your arms or legs, otherwise vertebral displacement may occur. Rise slowly. Roll over onto your side, get on all fours, and then you can stand up completely.

Over time, you can slightly increase the thickness of the roller.
The set of exercises does not need to be performed several times a day; it is enough to do it in the morning or evening. But training should be carried out regularly and preferably at the same time. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr

CONSEQUENCES OF SCOLIOSIS

Why is scoliosis dangerous in childhood? With scoliosis, not only does the posture deteriorate, which is an aesthetic defect and a reason for complexes and psychological trauma in the child. It is more unfortunate that all internal organs are displaced, not only muscles and bones are deformed, all systems and vital processes of the body suffer. This negatively affects overall health and leads to the following problems:

• headaches, migraines;
• fast fatiguability;
• disruption of the heart and respiratory system;
• development of osteochondrosis and spondylosis;
• chest deformation;
• disruption of internal organs and secondary diseases due to scoliosis.

What else is dangerous about scoliosis? It can lead to vision loss. Scoliosis leads to constant overstrain of the neck muscles, which contributes not only to headaches, but also to problems with hearing and vision. Therefore, treatment for this disease should be started immediately.