Scoliotic disease (scoliosis)

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scoliosis of 1 degree
Fig. 41. Scoliosis of I degree

Under the scoliosis is meant spinal deformity, characterized by its lateral curvature (Fig. 41). However, purely lateral curvature of the spine deformation him in the frontal plane is observed only at very early stages of the disease. As it progresses and increase the degree of deformation of the spine in the frontal plane curvature occurs it and in the sagittal plane (kyphoscoliosis, largescales)and curl (torsion) around the vertical axis. Such a complex multi-axis deformation of the spine inevitably leads to the change of the form of ribs and chest in General (rib hump) and disturbance of the normal configuration of the chest, and also to very serious functional disorders of internal organs and body systems. The first to suffer the function of the respiratory system, and then and cardiovascular that severe forms of the disease almost always leads to chronic hypoxia. Long-term oxygen deficiency inevitably affects the development of the whole organism. Not less serious anatomical and functional disturbances occur in the digestive and urinary systems. Not so rarely severe gipokaliemicski diseases are accompanied spinal disorders after involving in pathological process of the spinal cord (from the lungs of radicular manifestations to extremely dangerous, sometimes quite rapidly developing paralysis).
Thus, scoliotic disease is not the local curvature of the spine and severe disease involving in pathological process all of the most important systems and organs of a human body.
The percentage incidence of scoliotic disease among children is on average from 2 to 9. More often scoliotic disease suffer girls (ratio to boys about 6:1)due to their less than perfect physical development and the weakness of the muscles (due to lower motor activity).
Scoliosis is observed in many diseases (rickets, dystrophy, chronic lung disease), being in most cases one of their manifestations.
On the basis of pathogenetic allocate scoliosis: discogenic, gravitational, mitotic.
Discogenic scoliosis is developing on the ground dysplastic syndrome (about 90%). Metabolic disorders of the connective tissue thus lead to a change in the structure of the vertebrae, causing weakening the relationship of the intervertebral disc with vertebral bodies. In this place there curvature of the spine and the displacement of the disk. Simultaneously shifted jelly (pulpous nucleus: it is located not in the center, as usual, and closer to the convex side of curvature. This, in turn, causes the initial inclination of the vertebrae, which makes the muscles of the trunk and ligaments, which leads to the development of secondary bending and scoliosis.
Gravitational scoliosis is associated with the contraction of the muscles, broad and rough scars on the body, obliquity of pelvis and other Direct cause, leading to deformation, are offset common centre of gravity and the weight of the body away from the vertical axis of the spine.
Mitotic scoliosis occurs because of polio, myopathy and other diseases, leading to functional insolvency trunk muscles.
By morphological signs of scoliosis can be divided into structural and non-structural.
Structural scoliosis is scoliosis, in which there are changes in the structure of the vertebrae that are included in the arc curvature, including the wedge shape of the vertebral bodies, their torsion (twisting).
Non-structural scoliosis is scoliosis, which include a variety of functional state (scoliotic posture, antalgic pose with sciatica - the so-called reflex pain of scoliosis and other).
Localization peaks curvature scoliosis divided into Wernigerode, breast, the thoracolumbar, lumbar. In addition, there are the so-called combined scoliosis with two primary distortions: breast (top curvature at the level of DVIII-IX) and lumbar (top curvature at the level LII). This is a fairly common type of scoliosis.
According to the form of the curvature distinguish P - and S-shaped scoliosis.