Kyphosis of the spine
The term "kyphosis" refers to the bending of the spine by the convexity of the back. Normally, the adult spine is not straight, but has a slight bend in the thoracic region - physiological kyphosis, as well as a similar natural bend in the sacral section. In contrast to these bends, there are two bends in the opposite direction( anterior) - in the cervical and lumbar regions. Due to this structure, the damping properties of the spine are ensured, and a minimal load is provided for each individual vertebra.
If the thoracic kyphosis is strengthened, i.e.the angle of the bend of the spine in the thoracic region exceeds the normal value, then it is a pathological kyphosis. This is a serious disease, the treatment of which should be addressed as soon as possible.
Why does the thoracic kyphosis develop?
Kyphosis of the thoracic spine can develop as a result of congenital disorders of the spine. Such pathological kyphosis, as a rule, is found already in the second half of the child's life, when he begins to stand and walk.
Other causes of kyphosis are:
- spine trauma;
- disorders of posture;
- disease( rickets, rheumatoid arthritis, spinal tuberculosis, etc.);
- age changes.
Kyphosis can be determined visually according to the patient's posture: a "round" back, shoulders are inclined downwards and forward. Independently, the disease can be determined by conducting a simple test: you should lean your back against the wall and, without tipping your head, touch the wall with the back of your head. If this is done problematically, then, most likely, there is a pathological kyphosis of the thoracic region.
In addition, the disease is accompanied by pain in the thoracic spine, respiratory failure, muscle spasms.
Confirm the diagnosis with radiography, computed tomography or magnetic resonance imaging. These methods also provide an opportunity to establish the degree of the disease.Degrees of kyphosis
There are three degrees of disease:
- Easy( 1 degree) - occurs with a slight increase in the bending of the spine( up to 30 degrees).This form of kyphosis with timely treatment is quite easy and quickly amenable, but, unfortunately, it often goes unnoticed.
- Moderate( 2nd degree) - the curvature is not more than 60 degrees. The clinical picture with this form is already clearly pronounced, but a long course of treatment can change the situation.
- Heavy( 3 degree) - the bending of the thoracic region is more than 60 degrees. This form is characterized by the presence of a hump and is complicated by degenerative changes on the part of the spine, changes in internal organs. Kifosis of the third degree is accompanied by severe pain and can lead to complete disability.
How to cure kyphosis?
Treatment of the kyphosis of the thoracic spine is performed depending on the degree of the disease and taking into account the causes that caused it. In childhood and adolescence, kyphosis is easiest to treat, which usually includes:
- manual therapy;
- curative gymnastics;
- wearing a corset.
In addition, it is recommended to sleep on a hard surface, regular physical activity, a ban on wearing heavy weights.
In adulthood and with a severe degree of disease, conservative methods of treatment are aimed at reducing the pain syndrome and improving the mobility of the spine, forming a correct posture to counteract the effects of kyphosis. Unfortunately, to align the vertebral column after the period of skeletal maturity( after 16 years) will not succeed.
In this case, only surgical treatment can help. However, carrying out an operation that can reduce deformation involves a number of risks, therefore it is appointed only in extreme cases.
Classification of kyphosis: types, degrees, forms, species
Kyphosis is translated from Greek as "hunchbacked" or "bent".This is an innate or acquired curvature of the spine, which can be physiological or pathological.
About 10% of the world's population suffers from this disease of varying severity.
Kyphosis occurs in children, adolescents and adults, and it is more often diagnosed in men than in women.Contents
CongenitalFormed in fetal development of the fetus and in 30% combined with diseases of the urinary tract.
Congenital kyphosis arises from an anomaly in the development of the vertebrae( they may be wedge-shaped, semi-vertebral, butterfly-shaped and others), rotational dislocation of the spine( an anomaly occurs between two vertebral sites in which lordosis or scoliosis is formed), disruption of separation into separate vertebrae.
Congenital appearance is accompanied by neurological diseases( paralysis of the lower body, violation of urination, etc.).
The formation of the spine in the fetus occurs at the 6-8 week of development.Wrong development of vertebrae occurs under the influence of adverse factors that affect a pregnant woman.
Kind of kyphosis associated with the genetic characteristics of the vertebrae. The cause of the disease is genetic mutations of .Genotypic kyphosis is inherited by the dominant type.
The disease occurs in the thoracic spine due to a compression fracture of the vertebral bodies. Because of the injury, the height of the vertebrae decreases, the intensity of the arc increases.
Mobile( postural, functional)
Kyphosis develops in children older than 7 years and adolescents during periods of intense bone growth.
The main reason for the appearance is the psychological , when the child is shy of his height and begins to stoop. If you pay attention in time to your posture, you can correct it and avoid the development of the disease.
In advanced cases, the vertebrae acquire a wedge shape, and the disease progresses.
It is formed in children older than 6 months, patients with rickets .But in some cases, rickety kyphosis develops in older children and adolescents who have suffered rickets in early childhood. Rickets leads to softness of the vertebrae, weakness of the ligaments and muscles of the spinal column. As a result, the spine does not withstand the loads, the vertebrae shift, kyphosis develops.
Senile( senile)This kind of kyphosis develops in the elderly, more often in women.
disease occurs due to aging of the anatomical spine formations : vertebrae, muscles, intervertebral discs, ligaments.
With age, the vertebrae become softer, the intervertebral discs begin to sag and stop reliably performing their functions, and the ligaments lose elasticity.
Because of the appearance of weak points, the spinal column can not fully withstand loads, curvatures appear. This leads to the formation of senile kyphosis.
With this kind of kyphosis , a bend is formed along the entire arc of the spine .This is a physiological phenomenon in children under 1 year. Total kyphosis at this age is considered as a stage of development of the spine.
Tuberculosis microbacteria destroy intervertebral discs and vertebral bodies. Kyphosis develops with tuberculous spondylitis in people with reduced immunity .In recent years, it is rarely diagnosed.
Kind of kyphosis, named for the shape of the bulge .In the course of the disease, an angle is formed, the apex of which is directed backward.
Not a pathology of and is formed in children 7 years and adolescents during puberty with normal development of the spine.
Special case-Scheierman-MauThis type of occurs only in adolescents during the intensive growth of ( 14-16 years).It occurs in 1% of children, and in 30% of kyphosis is combined with scoliosis.
In the case of the Scheierman-Mau , the shape of several vertebrae changes: they acquire a wedge shape. Vertebrae lose their functions, at this time the muscles of the back are stretched, a constant feeling of fatigue arises.
As a result of these changes, the thoracic region tilts forward, kyphosis occurs.
Exact causes of Sheyerman-Mau's disease have not been clarified, but doctors suggest three:
- Excessive growth of bone tissue( congenital).
- Microtrauma of the spine, which appeared due to osteoporosis.
- Pathology of development of the muscles of the back.
Kyphosis is distinguished not only by species, but also by the degree of development.
Degrees of disease
Modern medicine allocates 4 degrees of kyphosis , which are determined only by X-ray images. For this , the Cobb's method is used: tangent lines are drawn to the vertebral terminal plates. From them perpendiculars are built inwards. By the resulting angle and you can determine the degree of the disease.
- 1 - the angle of curvature does not exceed 40 degrees;
- 2 - angle from 40 to 50 degrees;
- 3 - angle from 50 to 70 degrees;
- 4 - angle of more than 70 degrees.
Common gradation of degrees of pathology
Traumatology orthopaedists and vertebrologists often use a different gradation of kyphosis degrees:
- Hyperkifosis - pathology with a curvature angle of more than 50 degrees.
- Normokifose - the angle of the radiograph is from 15 to 50 degrees.
- Hypokyphosis - pathology angle does not exceed 15 degrees.
Kyphosis can be:
The disease occurs due to the pathological development of the vertebrae when the arches and processes are not inflated. With congenital kyphosis, infringement of the physiological concavity results in infringement of the nerve roots.
There are several reasons for the change in the size of the kyphotic arc: rachitic( lack of vitamin D in the child's body), static( age changes in the spine), infectious( influence on the structure of the spine of bacterial inflammation or tuberculosis), total( kyphosis develops under the influence of diseases of the spineFor example, the curvature of the spine occurs with Bekhterev's disease).
Degree of disease progression
Depending on the time of development and course of kyphosis, two degrees of disease are classified:
- Slowly progressive .If the convexity angle increases by no more than 7 degrees within 12 months.
- Rapidly progressive. The disease develops rapidly, and the convexity angle is increased by 7 or more degrees annually.
Type( localization of the top of the arc)
The disease is classified and by localization of the apex of the arc.
The following types are distinguished:
- Cheyno-thoracic. The top of the bulge is located in the area of the upper thoracic and lower cervical vertebrae.
- of the Upper Chest. The vertex is located between the vertebrae of Th3-Th6.
- Mildred chest. Kyphosis is localized between Th7 and Th9.
- of the Lower Chest. The location of the node is Th10 and Th11.
- . The convexity is at the level of Th12-L1.
- Lumbar. The vertex is located at the level of L2-L5.
Depending on the time of onset, the disease can occur in patients of different ages. Kyphosis happens:
- is an infant disease - , which is diagnosed in children of the first year of life. Kifosis can be eliminated if you regularly put the baby on your stomach.
- for children - develops in children of school age.
- adolescent and adolescent - is often accompanied by Sheyerman-Mau disease. In adolescence, kyphosis develops much faster than in adults. This is due to the peculiarities of the structure and the accelerated growth of the spine.
- to adults - is formed due to degenerative-dystrophic changes and spinal column injuries.
For pathological kyphosis, three symptoms are typical that arise from the infringement of the nerve roots:
- pain in the upper back;
- weakness in the hands;
- numbness of limbs with 2 and 3 degrees of disease.
In case of complications, the patient may experience breathing disorders, cardiovascular system, gastrointestinal tract. This is due to the displacement of the chest and a violation of its mobility.Patients with kyphosis often complain of pain in the interblade area, under the left and right scapula. But convexity formation at the first degree of the disease often occurs asymptomatically .
At 2 and 3 degrees of kyphosis, neurological disorders may appear: chest pain and numbness of the hands. Doctors distinguish several stages of kyphosis, depending on the severity of the neurological manifestations:
- A - the patient completely lost sensitivity and the ability to move;
- In - the person can not move, but the sensitivity remains;
- With - the patient is moving, but there is no functional activity;
- D - motor activity is not disrupted;
- E - neurological disorders are absent.
Kyphosis 1 degree is asymptomatic, but for successful treatment it is important to detect the disease at this stage.
|Kyphosis is a disease that can be congenital or acquired. It affects people of all ages and, depending on the degree and localization, manifests itself in different ways. Convexity of the spine can appear in the fetus due to the complicated course of pregnancy, during childhood and adolescence during intensive growth of the spinal column, after the rickets have suffered, due to incorrect posture, in adulthood after infectious diseases and in the elderly due to bone deteriorationsystem.|
Kyphosis degrees 1, 2, 3 - characteristics and treatment of
It is not difficult to determine kyphosis, because at least the appearance of the patient speaks about the presence of this ailment. In the early stages of development, this is just a stoop that persecutes a person constantly, and when the disease is neglected, you can see a pronounced hump. It is important to note that not always the patient has severe pain in the back, so the diagnosis is based on examination.
Causes and features of the
pathology The healthy spine has small bends forward in the cervical and thoracic region, as well as bending back at the level of the thoracic region. This physiology allows you to evenly distribute the load on the vertebrae, maintain maximum flexibility and move normally. With the increase in these bends due to a sedentary lifestyle, trauma or hereditary predisposition, we have to talk about the appearance of kyphosis. Most often it occurs in the cervico-thoracic region, and is especially often observed in people engaged in office work. It is important to note that back pain begins to appear during the transition of kyphosis to the second stage, when the incorrect posture and stoop are more pronounced.
Characteristics of the degrees of kyphosis
Different medical publications indicate different gradations of kyphosis degrees. In some there are only four, in others the fourth stage is part of the third. In any case, the following degrees are considered to be generally accepted:
- I - curvature is 30-40 degrees( stoop and light pain that appear during physical exertion);
- II - curvature 40-50 degrees( there are aching pains in the back, strengthening of which is possible with prolonged walking or staying in one pose);
- III - a curvature of 50-70 degrees, accompanied by the appearance of a hump, visible through clothing and severe pain, not only in the back, but also in the internal organs.
The fourth degree, at which the spine bends more than 70 degrees, practically does not stand out, as such cases are rare. As for the first degree, when the curvature starts at 30 degrees, it is only appropriate in case of thoracic kyphosis, for which the readings of 15-30 degrees are normal. Given that the normal physiological curvature of the cervical and lumbar spine suggests less than 15 degrees, then for them, the first degree of kyphosis can begin with a mark of 15 degrees.
Treatment of different degrees of the disease
The degree of kyphosis 1, 2, 3 determines the specificity of treatment, however, conservative therapy is almost always initially prescribed. This is sport, gymnastics, diet, wearing a special orthopedic corset, straightening the posture, etc. If there has been a change in the shape of the intervertebral discs and vertebrae, medication may also be prescribed. Surgery is used only for serious deformities of the spine, and also if a specific kyphosis is diagnosed, for example, Sheyermann-Mau, when it is necessary to carry out a two-stage operation that reconstructs the normal arch of the spine. Therefore, you can not always cope with kyphosis on your own, and it is better to consult a doctor.
Kyphosis of the thoracic spine: photos, symptoms, treatmentThe spine of a person without pathologies of development, when viewed in the sagittal plane, presents a series of bends of physiological properties. The bend in the inner side is characterized by lordosis in the cervical and lumbar spine, the kyphosis of the thoracic or sacral divisions is characterized by an outward bend. Such bends retain the mobility and flexibility of the spinal column, promote the maintenance of various loads. Normal physiological kyphosis should not exceed a 45-degree deviation. Curvature exceeding the norm refers to vertebral pathologies.
The causes of kyphosisThe development of the disease manifests itself for many reasons:
- pathology of the intrauterine nature;
- consequence of injuries and surgical interventions;
- due to pathological compression fractures of the vertebrae;
- consequence of the formation of incorrect posture or psychological stress;
- consequences of disc hernia and compression of nerve roots;
- neoplasm on vertebral discs;
Classification by speciesThe manifestation of functional kyphosis is due to the muscular weakness of the back. It looks like the usual stoop, acquired in the wrong position while working at a table or the consequence of a psychological factor, when they are shy of their growth, involuntarily slouch, trying to be lower. Often the psychological factor is expressed in girls during puberty, when they slouch, involuntarily trying to hide the growth of the breast. When the back is placed horizontally on a solid surface, kyphosis does not appear. Also disappears with an independent desire to straighten. With x-ray, no vertebral anomalies are detected. The young dorsal kyphosis or Sheyerman-Mau disease is characterized by a large degree of bending deflection( up to 75 grades).Such deformation manifests itself as a result of hernia formations in the thoracic intervertebral discs, which is the reason for the formation of several wedge-shaped vertebrae. Versions of pathology formation are numerous:
- hypertrophy of anterior ligament of intervertebral discs;
- avascular necrosis of hyaline cartilage, disrupting bone growth;
- or excessive growth of bone tissue on intervertebral sites;
- pathological processes in muscle tissue;
- is a consequence of osteoporosis and many other versions.
- 1) Paralytic appearance is a consequence of cerebral palsy or poliomyelitis. Complicated by deformation of the spinal column.
- 2) Post-traumatic appearance is the result of injuries and fractures in the thoracic or lumbar spine.
- 3) Post-operative form of kyphosis - associated with unsuccessful stabilizing operations on the spine.
- excessive loads;
- is a consequence of radiation therapy.
Symptoms of kyphosis and stageFew people pay attention to the seriousness of such a disease. Well, what can be dangerous in the usual stoop? Kyphosis, and its symptoms from the degree of curvature of the spine expressed:
- 1) Hypokyphosis with a curvature angle of up to 15 degrees.
- 2) Normal kyphosis with a bending angle reaching 50 degrees.
- 3) Hyperkifosis, when the bend exceeds 50 degrees.
- with painful spasms in the bend area;
- numbness and weakness in the legs;
- heart rhythm disturbance;
- problems with breathing and digestion( in complicated cases);
- is a violation of sexual functions.
- a decrease in free chest space;
- limited mobility of the chest;
- difficulty breathing.
- definition of genetic predisposition - an anamnesis of the disease in the family.
- the time of manifestation of the primary signs of kyphoid bending;
- determine the level of progression of the disease from previous pictures( if any).
- determine the nature of the pain, if any.
- detecting the presence of intestinal dysfunction or disorders in the urinary system
- assessment of motor functions.
- revealing the presence of surgical interventions on the spine in the anamnesis.
- determination of the motor functions of the back;
- determination of the patient's flexibility in different directions;
- revealing the lesions of certain nerve endings when evaluating reflexes and muscle strength.
- uses special tests to identify irritated or clamped nerves.
- 1) X-ray examination in various positions( standing or lying), front, side and lateral bending, helps to determine structural changes in the spine and to measure the angle of curvature.
- 2) The MRI method allows you to view changes in nerve fibers and changes in the spinal cord.
- 3) The CT method allows obtaining more complete information on structural bone changes.
How to treat the kyphosis of the thoracic spine?The treatment plan is always tailored to individual needs. Consists of their conservative treatment and extreme method - surgical. Conservative treatment of kyphosis , which includes drug therapy, is aimed at reducing pain symptoms. It should be clearly recognized that no drug therapy is able to completely cure the curvature, its task is to facilitate the course of the disease. When kyphosis of the thoracic spine, complicated by osteoporosis, treatment of the background disease is carried out, preventing various vertebral fractures. Assignment:
- hormone therapy;
- vitamin complex;
- exercise complex with loads.
- 1) In view of training programs aimed at the correct mechanics of maintaining the vertical position of the body;
- 2) Recommendations for maintaining the maximum active level;
- 3) An individually formulated exercise plan for stretching exercises and compulsory swimming procedures.
Surgical treatment of kyphosisSurgical intervention in thoracic kyphosis is applicable in the following cases:
- 1) When conservative methods do not produce the desired results and pain symptoms are not manageable
- 2) In cases of progressive kyphosis, to prevent the effects of severe forms of kyphosis.
- 3) In some cases, with large physical deformities caused by curvature.
- to reduce the deformation of the spine;
- retention of afferent connections, eliminating pressure on nerve endings;
- protection against further damage.
Prevention of kyphosisPrevention aimed at preventing the disease contains several rules:
- fitness for the young and exercise therapy for the elderly.
- with sedentary work recommended gymnastic exercises to maintain normal muscle tone.
- visit a child psychologist or explanatory work with psychological problems that cause stoop.
- match the size of the desk and chairs according to the height of the person.