Anatomy of the spine: natural curves and pathologies

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.

Features of the vertebral sections

The anatomical features of the human allow us to distinguish five parts with a certain number of vertebrae:

• cervical – 7;
• breast - 12;
• lumbar - 5;
• sacral - 5;
• coccygeal type.

The spinal column does not have an exact number of vertebrae in the last part. It distinguishes from 2 to 5 units. In the area of ​​the sacrum and coccyx they are connected motionlessly.

Experts highlight the following features:

1. In the cervical region, the area is characterized by high mobility. It contains two vertebrae of non-standard structure, designed to connect the bones of the head and spine. Due to the combination, rotations and tilts of the skull occur.
2. In the chest - this part is characterized by a lower rate of mobility. It provides support for the body and protection of internal organs.
3. In the lumbar region, it contains the most massive structures, the size of which is associated with bearing the bulk of the body weight.
4. In the sacral - 5 vertebrae are necessary to support the vertical position. They also take part in distributing the total load.
5. In the coccygeal region, the area is necessary for attaching ligaments and other anatomical structures.

The classic structure of the spine is not always observed. With an intrauterine developmental anomaly in the lumbar region, an additional vertebra is formed due to the lack of its fusion with the sacral region. There are other options, in which 4 vertebrae appear in the lumbar region, and 6 in the sacrum area.

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

Rachiocampsis

Treatment of scoliosis

Treatment of lateral curvatures of the spine can be conservative or surgical. Conservative therapy programs include specially designed exercise therapy complexes, breathing exercises (according to Schroth or similar programs), corsets, reclinators, physiotherapeutic procedures and massage.

• Physiotherapy
  . When the angle of deformation is up to 15 degrees, specialized gymnastics is prescribed. Exercises are selected individually; in the initial period they should be performed under the supervision of an instructor in order to master the correct technique. The goal of gymnastics is to strengthen the back muscles and create a good muscle corset.
• Wearing a corset
  . When the angle of curvature of the spine is 15-25 degrees, exercise therapy classes are supplemented by wearing corsets. At an angle of up to 20 degrees, the corset should be used at night, more than 20 degrees - most of the day and night (at least 16 hours a day). Corrective corsets Milwaukee, Chenault and their analogues are used. The wearing period is 6 months or more. As the child grows and the deformity decreases, the corsets are replaced. Corrective devices can eliminate not only lateral and anteroposterior curvature, but also rotation of the spine.
• Massage
  . Therapeutic massage for scoliosis helps strengthen the back muscles and normalize lymph and blood circulation. A course of treatment consisting of 15-20 sessions is carried out 2-3 times a year.
• Physiotherapy
  . Patients are prescribed hydrotherapy, heat therapy (paraffin, ozokerite) and electrical stimulation.

Indications for surgery for scoliosis are determined individually and depend on the age of the patient, the type and location of the curvature and some other factors. The generally accepted criteria for the need for surgical treatment are a curvature of 45-70 degrees as measured by Cobb in combination with the ineffectiveness of conservative treatment, persistent pain, steady progression of scoliosis, impaired pulmonary and cardiac function. Operations according to Chaklin, Tsilke, Dubusset, Harrington and others are used.

The essence of all surgical techniques is to remove and hold the spine in the correct position with the help of metal structures. In this case, the fixed part of the spine loses mobility. Surgical interventions are performed from an anterior or posterior approach. To fix the spine, metal rods are used, which are attached to the vertebrae with screws or hooks. Subsequently, the fixed vertebrae become fused into a single block.

Treatment of kyphosis

Therapeutic tactics depend on the cause of the curvature of the spine, the degree of kyphosis, the patient’s age, his condition, and other factors. With 1-2 degrees of kyphosis, a complex conservative therapy program is drawn up, including exercise therapy, massage, breathing exercises, physiotherapy, mud therapy and reflexology.

In case of grade 3-4, dysfunction of internal organs, severe pain, rapid progression of spinal curvature, significant cosmetic defect and the presence of severe neurological disorders, surgical operations are performed. Treatment consists of correcting the bend using special metal structures fixed to the vertebrae with hooks or screws. Sometimes it is necessary to perform several operations to achieve the desired effect.

Treatment of lordosis

Treatment tactics depend on the cause and degree of spinal curvature, the patient’s age, his state of health and other factors. If possible, therapeutic measures are taken to eliminate the cause of the deformity. A complex of exercise therapy, massage, heat and hydrotherapy is prescribed. Some patients are recommended to wear a bandage.

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.