Scoliosis - what is it? Causes, symptoms, diagnosis and treatment. Scoliosis in children and adults.

Scoliosis is one of the most common types of spinal curvature, which usually appears between the ages of 12 and 14. Unlike other curvatures (kyphosis or lordosis), scoliosis is characterized by a zigzag curve of the spinal column. This disease can be either congenital or acquired as a result of incorrect posture, carrying a heavy bag on one shoulder, uneven physical activity, or injuries.

In addition, in children it can appear due to past illnesses - rickets, muscle atrophy. The most dangerous age categories in this sense are those that are accompanied by particularly intensive growth. These are ages 4-6, 10-14 years. At the same time, we must not forget that curvature of the spine can also develop in adulthood, due to incorrect habits, anatomically incorrect sleeping position, professional loads - for example, in loaders who are accustomed to carrying heavy objects in only one hand or bending over in one hand side.

Scoliosis is usually determined by external signs due to:

• Uneven distance between the shoulder blade and arm on one side of the body and on the other.
• Asymmetries in the position of the shoulder blades.
• Noticeable curvature of the spinal column when bending forward.

It is worth considering that scoliosis is not just a violation of posture. This is a serious disease, which, in addition to aesthetic defects, can lead to the following consequences:

• Pinched and damaged spinal nerves. At the initial stage, this is fraught with headaches, numbness in the limbs, and a deterioration in general well-being and mood. In its most extreme manifestations, this can even lead to paralysis and loss of limb function.
• Violation of the anatomically correct location of internal organs. It is important to understand that the human body is an integral structure in which each element is closely connected with the others. Incorrect position of the spine leads to curvature of the entire skeleton, disruption of the position of the chest, and displacement of internal organs. As a result, their blood circulation is impaired and their ability to perform their functions deteriorates.
• Constant back pain, difficulty breathing, periodic blurred vision, high fatigue. Another consequence is the loss of flexibility and natural mobility in the spine, resulting in a gradual transition to a passive lifestyle and fear of physical activity.

As we have seen, scoliosis is a dangerous disease that should definitely be treated and should not be neglected under any circumstances, since it tends to progress, reducing the chances of a complete cure and increasing discomfort. Mild forms of this disease are treated by acquiring correct posture, healthy habits, and stopping unnatural effects on the spine. Massage and physical therapy, physiotherapy, and swimming are also quite effective. An advanced stage can only be corrected surgically.

Signs and types of scoliosis

According to pathogenetic characteristics, discogenic, gravitational and miotic scoliosis .

Discogenic scoliosis develops due to dysplastic syndrome. Metabolic disorders in connective tissue lead to changes in the structure of the spine, as a result of which the connection between the intervertebral disc and the vertebral bodies at the apex of future curvature and displacement of the disc weakens. Together with them, the nucleus pulposus shifts, which is now located not in the center, as usual, but closer to the convex side of the curvature. This, in turn, causes a primary tilt of the vertebrae, which causes the development of mechanisms that balance the spine: tension in the trunk muscles and ligaments, which leads to the development of secondary curvatures and the formation of scoliosis.

The basis of gravitational scoliosis is muscle contracture, extensive and rough scars on the torso, pelvic distortion, and more. The immediate cause leading to deformation is a shift in the center of gravity and the action of body weight away from the longitudinal axis of the spine.

Miotic scoliosis occurs due to poliomyelitis, myopathy and other diseases leading to functional failure of the trunk muscles.

Based on morphological characteristics, scoliosis is usually divided into structural and non-structural . Structural scoliosis is understood as scoliosis, in which there are changes in the structure of the vertebrae included in the arc of curvature, including the wedge-shaped shape of the vertebral bodies and their torsion (twisting). Non-structural scoliosis includes various functional conditions, for example, scoliotic posture, antalgic posture with radiculitis (the so-called reflex-painful scoliosis) and others. These types of scoliosis were previously called professional, school, senile, functional scoliosis ; these terms are not currently used.

Structural scoliosis is divided into so-called:

• Idiopathic scoliosis;
• Neurogenic scoliosis - in patients with poliomyelitis, spastic paralysis (spastic scoliosis), spinal cord tumors, syringomyelia, etc.;
• Myogenic scoliosis - in patients with muscle atrophy, arthrogryposis and others;
• Congenital scoliosis due to neurofibromatosis;
• Scoliosis associated with mesenchymal disorders , for example with Marfan disease;
• Scoliosis with collagen diseases;
• Traumatic scoliosis due to vertebral fractures, after laminectomy, due to cicatricial changes in the pleura or scars on the skin after burns (cicatricial scoliosis);
• Scoliosis due to degenerative changes in cartilage and bone tissue;
• Scoliosis due to rickets;
• Scoliosis in infectious diseases of the spine (spondylitis);
• Scoliosis with spinal tumors;
• Scoliosis as a result of the abnormal structure of the lumbar vertebrae and their joints (spondylolysis and spondylolisthesis, abnormalities of the articular processes).

Of greatest practical interest is idiopathic scoliosis , which accounts for approximately 90% of all cases of scoliosis. It is based on metabolic disorders in connective tissue. Depending on the age at which the spinal deformity appeared, idiopathic scoliosis is divided into infantile (under 3 years of age), childhood (3 to 10 years of age) and adolescent (over 10 years of age).

According to the localization of the apex of the curvature, in accordance with the currently widespread classification proposed by Ponsetti and Friedman (JV Ponsetti, V.J. Friedman), scoliosis is divided into upper thoracic - the apex of the curvature is located at the level of Thm_VI (accounts for 1.3-3.6% from all types of S.), thoracic - the apex of the curvature is located at the level of ThVIII_IX (according to various sources, it is 21.7-42.9% of all types of S.), thoracolumbar - the apex of the curvature is usually located at the level of ThXI-Lr (occurs in 15.8 - 24.7% of cases), lumbar - the apex of the curvature is located at the level of Ln (8.8 - 24% of cases S.). In addition, there is a so-called combined scoliosis with two primary curvatures: thoracic (apex of curvature at the level of ThVIII_IX) and lumbar (apex of curvature at the level of Ln). This is a fairly common type of scoliosis, with an incidence ranging from 16.7 to 37% of scoliosis cases. Based on the shape of the curvature, they distinguish between C- and S-shaped scoliosis .

Recovery prognosis

It is possible to completely get rid of the manifestations of kyphoscoliosis only until the active period of skeletal growth ends. It usually ends at age 15, but some experts insist that treatment should end before age 12.

Pathology of the first degree is cured in almost 100% of cases, the second degree can be eliminated in 50-70% of cases. In the presence of advanced stages of kyphoscoliosis, the prognosis is unfavorable and usually it is only possible to stop the deterioration and relieve the patient from the symptoms of the pathology.

Clinical picture of scoliosis (set of disease manifestations)

The factor that determines the clinical picture of scoliosis is the magnitude of the curvature . In our country, the four-degree system for assessing the magnitude of spinal curvature proposed by V.D. Chaplin (1958) is used. According to this system, degree I includes curvatures from 5 to 10°, degree II - curvatures from 11 to 30°, degree III - from 31 to 60°, and degree IV - from 61 to 90° or more.

At an early stage, scoliosis is manifested by a primary tilt of the vertebrae at the apex of the future main curvature, accompanied by secondary curvatures, which at this moment are functional in nature and are revealed only on radiographs taken with the patient standing; They disappear in photographs taken in the supine position. With the further development of scoliosis, the tilt of the vertebrae in the area of ​​the apex of the curvature forms a real arc, and the secondary curvatures gradually lose their functional character. During this period, there is a pronounced asymmetry of the intervertebral discs with a symmetrical shape of the vertebral bodies , but the latter are already somewhat turned to the convex side. In this process, the functional component first prevails - rotation of the vertebrae, which is then replaced by a structural component - torsion, or twisting, of the vertebrae, in which not only the shape is disrupted (the vertebral body is displaced relative to the posterior semi-ring towards the curvature), but also the structure of the vertebra. In particular, the bony trabeculae of the cancellous bone, in contrast to the normal vertical and horizontal directions, acquire a spiral arrangement. With the appearance of primary inclination, the muscles of the trunk begin to take part in the formation of deformation, which not only counteract the inclination, but also cause the development of secondary curvatures. At the earliest stages of deformation development, the nuclei pulposus at the apex of the main curvature are shifted to the convex side, while at the same time in secondary curvatures they find themselves in their usual place. With further development of the deformity, the vertebral bodies acquire a wedge-shaped shape at the apex of the curvature, which makes correction of the deformity noticeably more difficult. The severity of structural changes depends not so much on the magnitude of the deformation as on the time of its existence.

Curvature of the spine causes a number of changes in other organs and, above all, deformation of the chest. In this case, the ribs are first deformed - on the convex side of the curvature of the spine they form the so-called. costal hump, and on the concave side the posterior sections of the ribs are flattened. In this regard, the volume of the chest decreases and the mechanism of its respiratory movements is disrupted. These changes in the skeleton are accompanied by dysfunction of the lungs and cardiovascular system. Atelectasis appears in the lungs , alternating with emphysematous areas. Against the background of these changes, pressure in the pulmonary circulation increases, which ultimately leads to the development of the so-called kyphoscoliotic heart. In severe scoliosis, these changes can cause the development of cardiac and respiratory failure , usually against the background of various respiratory diseases.

Spinal deformity changes the normal relationships of the patient's torso. On examination, there is an asymmetry of the waist triangles formed by the lowered arms and lower back. There may be an asymmetrical position of the shoulder girdles, a deviation of the body to one side in relation to the pelvis, the nipples of the mammary glands are located at different heights, and the navel is not located along the midline of the body. When examined from the back, curvature of the spine can also be detected in the sagittal plane. Most often, pronounced kyphosis is observed in the thoracic region - kyphoscoliosis , less common is lordosis - lordoscoliosis . Inspection data can be objectified by measurement or photometry. To do this, projections of the tops of the spinous processes, angles of the scapula, and iliac crests are drawn onto the patient’s body with a special pencil, and the patient is photographed through a special grid with a known cell size.

With compensated scoliosis, the plumb line, lowered from the apex of the curvature, passes along the intergluteal fold; with decompensated scoliosis , it shifts towards the curvature. The curvature of the spine in scoliosis includes a primary curvature and two secondary ones. With a combined type of curvature, there are two main curvatures. The task of clinical and radiological examination is primarily to determine the main curvature and, therefore, the type of scoliosis. To resolve this issue, the following criteria are used:

1. the main curvature is usually greater than the secondary ones;
2. the stability index of the primary curvature is always higher than that of the secondary ones;
3. of the three curvatures, the middle one is always the main one;
4. with decompensated scoliosis, the patient’s torso is deviated towards the apex of the main curvature. Torsion and wedge-shaped deformation of the vertebrae in the area of ​​the apex of the curvature on the primary curvature is usually more pronounced than on the secondary ones.

X-ray examination allows us to identify clinically undetectable forms of scoliosis, its level, accurately measure the magnitude of the curvature, which allows us to indicate its degree, establish secondary degenerative changes in the vertebrae and intervertebral discs, carry out differential diagnosis with other diseases of the spine, monitor the effectiveness of treatment, assess the condition and relative position organs of the chest and abdominal cavity, which is especially important for large curvatures.

X-ray of the lower thoracic, lumbar, sacral spine and part of the pelvic bones in lumbar scoliosis (direct projection): the amount of curvature determined using the Cobb method is 25°.

With severe scoliosis, the most informative is radiography in a direct projection (see figure). For small curvatures, radiography in the lateral projection does not lose its value (it should be carried out on the side towards which the apex of the curvature faces).

To determine the stability of the deformation, the stability index is calculated using the formula Jst = B/B1, where B and B1 are the angles of deformation in the standing and lying position. The type of scoliosis, degree of curvature, and stability index are determined by X-ray examination of the spine. The amount of deformation is calculated using the Cobb or Ferguson methods (scoliosometry).

Minor curvatures of the spine are most often first detected during an x-ray examination, since due to the rotation of the vertebrae, the line running along the spinous processes is always curved less than the line of the vertebral bodies. The lateral curvature of the spine is measured by the angle of its bend on a radiograph taken in a direct projection. With scoliosis , radiographs reveal asymmetry of the individual vertebral bodies. The more pronounced it is and the more vertebrae are involved in the process, the more pronounced the scoliosis. Typically, asymmetrical growth of the vertebral body is accompanied by rotation of the entire vertebra with its arch and processes. In the initial stage of development of scoliosis in children, it is difficult to perceive the asymmetry in the height of the right and left halves of the vertebral body. Therefore, practically the earliest sign of developing scoliosis , indicating disturbances in the growth of individual vertebrae, is their rotation, easily determined on a radiograph in a direct projection by the displacement of the images of the pedicles of the arches and the spinous process relative to the vertebral body.

Indirect significance in the diagnosis of idiopathic scoliosis may be the identification of dysplasia of other localizations, primarily the spine - fusion or nonfusion of arches and processes, bone block of two or more vertebrae, absence of one half of the body or vertebral arch, spina bifida in the lumbar or sacral regions, sacralization or lumbarization, especially asymmetrical, and more. Since all dysplastic deformations of the skeleton (both congenital and acquired) increase most intensively during periods of accelerated growth of the body, control X-ray studies should be carried out at this time with mandatory comparison of their results over time.

X-ray examination also makes it possible to assess the degree of overload of the intervertebral discs on the concave side and rotation of the vertebrae around the long axis of the spine, to identify dystrophic changes in them, pathological displacements of the vertebral bodies, associated osteochondrosis , manifested by marginal bone growths and subchondral osteosclerosis , decreased disc height, ossification of the ligamentous apparatus with the development of spondylosis, the development of deforming arthrosis in the facet joints - spondyloarthrosis, the appearance of zones of restructuring in the spinous processes, developing as a result of strong lateral traction of the ligaments during displacement of the vertebrae (Loozer zone).

Consequences of poor posture

If you ignore the deplorable condition of the spine, you may encounter such unpleasant consequences as spinal curvature, scoliosis, osteochondrosis, intervertebral hernia , etc.

Often, poor posture is accompanied by a decrease in the diameter or partial occlusion of blood vessels, as a result of which the supply of oxygen to the brain is suspended. This threatens coordination problems and partial paralysis.

Deformations in the cervical spine are especially dangerous, which lead to pinching and narrowing of the vessels of the cervical spine (can cause death).

As for children, the consequences for them are no less serious than for adults. Poor posture leads to increased fatigue, frequent headaches, and decreased performance and performance at school.

Treatment of scoliosis in children and adults

Treatment for scoliosis depends on the age of the patient, the type of scoliosis, and the degree of spinal deformity. Infant scoliosis is treated conservatively , placing the child in the correction position in corrective beds made of plaster or thermoplastic polyvik material; massage and passive gymnastics are also performed.

Children's scoliosis with I and II degrees of spinal curvature is also treated conservatively . An important condition for successful treatment of childhood scoliosis is a nutritious diet rich in vitamins, regular exposure to fresh air, and outdoor games. The child's bed should be hard, for which a wooden board is placed on the bed. The chair and table at the child’s workplace must correspond to his height. It is necessary to ensure that the child sits upright at the table, and his legs reach the floor. The correct installation of the light is also important, and in case of impaired vision, its correction is mandatory. Therapeutic gymnastics are systematically carried out and the wearing of corsets such as Milwaukee or TsNIIPP - CITO is often prescribed. Outpatient treatment of childhood scoliosis requires the active participation of parents.

Conservative treatment is also carried out in special boarding schools for children with scoliosis, where, simultaneously with education according to the regular program, the necessary round-the-clock treatment regimen has been created.

One of the leading means of conservative treatment of scoliosis is physical therapy . Physical exercises have a stabilizing effect on the spine, strengthening the muscles of the torso, allowing for a corrective effect on deformity, improving posture, external respiration function, and providing a general strengthening effect. For the methodically correct use of exercise therapy, it is necessary to establish the etiology of scoliosis , the localization, direction and degree of curvature of the spine, as well as the nature of the pathological process.

Exercise therapy is indicated at all stages of scoliosis development , but it gives more successful results in initial forms of scoliosis. Physical exercises that increase the flexibility of the spine and lead to its hyperextension are contraindicated. The complex of exercise therapy tools used in the conservative treatment of scoliosis includes therapeutic exercises, exercises in water, massage, position correction, elements of sports; Exercise therapy is combined with a regimen of reduced static load on the spine. Exercise therapy is carried out in the form of group classes, individual procedures (mainly indicated for patients with an unfavorable course of the disease), as well as individual tasks performed by patients independently.

The method of exercise therapy is determined primarily by the course of scoliosis . When the process is compensated (no signs of progression), therapeutic exercises are usually carried out with a group of children, using various types of physical exercises that develop correct posture, correct scoliosis, strengthen the muscular system, and others. In case of scoliosis with a tendency to progress, it is advisable to carry out exercise therapy individually with the patient lying down (on the back, stomach, side), using only exercises that intensively strengthen the muscles of the back and abdomen. Exercise therapy is combined with manual massage of the back and abdominal muscles and wearing a corset that fixes the spine.

The method of exercise therapy is also determined by the degree of scoliosis: for grade I, III, IV scoliosis, it is aimed at increasing the stability of the spine (stabilization of the pathological process), while for grade II scoliosis, it is also aimed at correcting deformity.

In case of congenital scoliosis, corrective exercises are contraindicated, as they can lead to decompensation. General strengthening exercises are used that expand the chest and improve posture.

For neurogenic scoliosis caused by paralysis, therapeutic exercises are carried out in a lying position with the aim of differentiated strengthening of muscles (usually the abdomen).

Correction of scoliosis when performing physical exercises is achieved by changing the position of the shoulder, pelvic girdle and torso of the patient. Exercises should be aimed at correcting the curvature of the spine in the frontal plane and the existing torsion of the vertebrae. Exercises that stretch the spine, for example, against a gymnastic wall, are used with great caution for the purpose of correction. Therapeutic gymnastics exercises should serve to strengthen the main muscle groups that support the spine - the erector spinae muscles, oblique abdominal muscles, quadratus lumborum, iliopsoas muscles and others. Among the exercises that help develop correct posture, balance exercises, balancing exercises, strengthening visual control, and others are used.

To correct the deformed chest due to scoliosis, exercises are used that both symmetrically expand it and help improve the excursion of the ribs on the sunken side. Massage of the back and abdominal muscles is carried out more intensively and for a longer time on the convex side of the curvature using deep rubbing, kneading, and tapping techniques. It is indicated for young children and for progressive disease. Elements of sports - breaststroke swimming (after a preliminary course of training), cross-country skiing, elements of volleyball, are indicated for children with compensated scoliosis. The effect achieved by using physical exercises is secured by correcting the position, for example, by placing the patient on his side with a bolster under the convex part of the spinal curvature.

In almost all cases of progression of the deformity, surgical treatment in order to prevent the development of severe scoliosis . The basis of surgical treatment is osteoplastic fixation of the spine : exposure of the spinous processes and vertebral arches, removal of the compact (cortical) substance from the arches and fixation of the vertebrae using grafts. Currently, the Harrington method - fixation and correction of spinal deformity using special metal distractors and contractors used together with osteoplastic fixation. Correction is also used using the Grutsy spring corrector (Grutsy operation) . In domestic orthopedics, corrective operations aimed at mobilizing the deformed spine have become widespread. Such operations include discotomy - dissection of intervertebral discs along the concave side; enucleation , that is, removal of the pulpy nuclei on the convex side of the curvature; discoepiphysectomy , in which intervertebral discs are excised along with the epiphyses of the vertebral bodies. For more severe curvatures, various types of wedge-shaped resection of the vertebral bodies at the apex of the curvature are used. These operations are combined with osteoplastic fixation of the spine.

The success of surgical treatment is largely determined by correctly performed subsequent treatment, which includes immobilization in a plaster bed for the first 10 days, wearing a high plaster corset (after correction of the deformity by discotomy). Immobilization in a plaster corset should continue for 1 year, and then in a removable corset with a holo-holder for another 1 year.

The nature of the surgical intervention is determined by the type of scoliosis, the degree of spinal deformity and the age of the patients. Thus, with thoracic scoliosis of initial III degree, discotomy is indicated first of all, with advanced III degree enucleation of the intervertebral disc, and with III-IV degrees wedge resection.

In adolescents with low growth potential and in adult patients, the application of a Harrington distractor is indicated.

Thoracic scoliosis with pronounced lumbar countercurvature requires two-stage surgical treatment. At the first stage, the lumbar curvature is corrected using Kazmin distractors, and 3 months after this, one of the corrective operations on the thoracic curvature is performed. The same tactics are also indicated for combined C- or S-shaped scoliosis.

In lumbar scoliosis, correction and fixation of the curvature using a distractor is primarily indicated, but in severe grade IV scoliosis, a wedge-shaped resection at the apex of the curvature may be necessary.

Surgical treatment of thoracolumbar scoliosis is also carried out, as a rule, in two stages. Upper thoracic scoliosis requires special attention , since it is difficult to correct an already developed deformity. This type of scoliosis requires early surgical treatment (discotomy or enucleation). Scoliosis, caused by any organic damage to the spine, spinal cord, muscles, requires first of all treatment of the underlying disease. For severe deformities, various corrective and stabilizing operations are used.

The prognosis depends on the type of curvature, its severity and the age of the patient. The prognosis for infantile scoliosis is quite favorable. With timely diagnosis and proper treatment, it is corrected by 2-3 years of age. Scoliosis that persists after this period, as a rule, leads to severe deformities in the future. Childhood scoliosis has a less favorable prognosis , but self-healing is possible in the younger group. In adolescent patients, the prognosis is serious. In older age groups, conservative treatment is ineffective. A more accurate prognosis can be established using various x-ray tests. For example, the Kohn test (expansion of the intervertebral space on the concave side of the curvature) can be detected in children aged 4-8 years; it indicates progression of the deformity. The Risser test (state of the iliac epiphyses) is based on data from James (JIP James), who believes that with the appearance of the ossification nucleus of the iliac epiphysis, progression of the deformity to 38° is possible, after completion of ossification and before fusion with the body of the ilium, the deformation can increase by 26 °, and after soldering - up to 18 °. The Risser test only indicates the possibility of progression of scoliosis, but does not mean the inevitability of the latter. According to I.A. Movshovich, the appearance in the caudal parts of the vertebral bodies on the convex side of osteoporosis indicates progression of the deformity (the so-called Movshovich sign ).

Prevention of scoliosis involves the prevention of scoliotic posture, timely treatment of diseases accompanied by scoliosis; in relation to idiopathic scoliosis - its timely treatment.

Code according to ICD10

Diseases of musculoskeletal tissue are in class XIII of the document, designated by the letter M and numbers 00-99 . It is worth noting that the diagnosis of “impaired posture” is absent in medical practice. This is just a symptom that indicates the presence of certain problems with the musculoskeletal system.

Video: “How to determine poor posture?”

Read more about posture correction methods:

• You can learn about the operating principles of electronic spine correctors here
• Reviews from doctors and the cost of magnetic correctors for posture formation can be found at the link
• Read more about the correct formation of posture in children at an early age on the page
• What is an orthopedic posture chair and how to use it?
• To find out if you can improve your posture by doing yoga, go here

ICD-10: M41 - Scoliosis

Diagnosis with code M41 includes 8 clarifying diagnoses (ICD-10 subheadings):

• M41.0 - Infantile idiopathic scoliosis;
• M41.1 - Juvenile idiopathic scoliosis;
• M41.2 - Other idiopathic scoliosis;
• M41.3 - Thoracogenic scoliosis;
• M41.4 - Neuromuscular scoliosis;

• M41.5 - Other secondary scoliosis;
• M41.8 - Other forms of scoliosis;
• M41.9 - Scoliosis, unspecified;

General description of thoracic kyphoscoliosis

In the patient's card, doctors can encrypt the disease with an international code, which looks like ICD 10: M40-M43 . When diagnosing kyphoscoliosis, it is important to accurately determine its severity, since the course of treatment and the possible outcome of the disease depend on this.

With kyphoscoliosis, curvature of the spine occurs in two projections

Attention! In a normal state, the human spine does not bend to the side; the same rule applies to the chest. If you notice even minimal curvature of a child’s torso, you should immediately consult a traumatologist and orthopedist.

Bibliography:

• Gurfinkel V.S., Kots Ya.M. and Schick M.L. Regulation of human posture, M., 1965;
• 3akrevsky L.K. Anterolateral spondlodesis in scoliosis, L., 1976, bibliogr.;
• Kazmin A.I. Two-stage surgical treatment of scoliosis, M., 1968, bibliogr.;
• Kazmin A.I. and Fishchenko V.Ya. Discotomy. (Etiology, pathogenesis and treatment of scoliosis), M., 1974, bibliogr.;
• Kazmin A.I., Kon I.I. and Belenky V.E. Scoliosis, M., 1981, bibliogr.;
• Kaptelin A.F. Rehabilitation treatment (physical therapy, massage and occupational therapy) for injuries and deformations of the musculoskeletal system, page 219, Moscow, 1969;
• Kosinskaya N.S. Disturbances in the development of the osteoarticular apparatus, L., 1966;
• Therapeutic physical culture, edited by S.N. Popova, page 108, Moscow, 1978;
• Maykova - Stroganova V.S. and Finkelstein M.A. Bones and joints in x-ray images, Torso, Leningrad, 1952;
• Movshovich I.A. and Rits I.A. X-ray diagnostics and principles of treatment of scoliosis, Moscow, 1969, bibliogr.;
• Moshkov V.N. Active correction of spinal deformities and flat feet in children and adolescents, Moscow, 1949; Reinberg S.A. X-ray diagnosis of diseases of bones and joints, book 2, page 172, Moscow, 1964;
• Tsivyan Ya.L. and 3aidman A.M. Morphogenesis of scoliosis, Novosibirsk, 1978, bibliogr.;
• Chaklin V.D. and Abalmasova E. A. Scoliosis and kyphosis, Moscow, 1973, bibliogr.;
• Shulutko L.I. Lateral curvature of the spine in children (scoliosis), Kazan, 1968, bibliogr.;
• James JIP Scoliosis, Edinburgh, 1976;
• My J.N.a. O. Scoliosis and other spinal deformities, Philadelphia ao, 1978;
• Roaf R. Scoliosis, Edinburgh - L., 1966;
• Georg Schmorl Herbert Junghanns Die Gesunde und die Kranke Wirbelsaule im Rontgenbild und Klinik, Stuttgart, 1957;
• A.I. Kazmin; P.L. Zharkov (rent.), A. F. Kaptelin (medical physicist).

Source: Great Medical Encyclopedia

Prevention of curvature of posture

To maintain spinal health, it is recommended:

• 
  Prevention of spinal curvature should be done from early childhood by walking regularly;

• sleep on orthopedic mattresses;
• keep your back straight when walking and while working;
• dancing, swimming, horse riding, fencing;
• wear comfortable shoes (the optimal heel height is 3-5 cm);
• take a contrast shower (provides increased muscle tone);
• avoid one-sided loading (for example, carrying briefcases or bags in one hand);
• lean on the back of a chair or armchair when working at a computer (it is advisable to choose orthopedic furniture);
• include in the diet fish, meat, fresh fruits and vegetables, various dairy products (sour cream, cheese, cottage cheese, kefir, etc.).

Video: “Gymnastics for children to correct posture”

Symptoms

Signs of scoliosis can be confused with signs of other spinal curvatures. It is worth paying attention to the following symptoms:

• when stretching the upper limbs, it is noticeable that they have different lengths;
• the line of the shoulders and shoulder blades is uneven (for example, one shoulder is higher than the other);
• the waist has an asymmetrical shape;
• the ribs protrude on one side;
• the pelvic bones are distorted.

A sign typical only for scoliosis is a misalignment of the pelvic bones. Other symptoms may occur when posture is poor, but disappear with conscious straightening of the back.

In the early stages, scoliotic disease is difficult to diagnose independently. It must be differentiated from postural disorders caused by weakness of the muscular corset, as well as kyphosis and lordosis.

Important! If you notice symptoms of scoliosis, consult your doctor. Do not self-diagnose or self-medicate. The information is posted on the website for informational purposes.