Scoliosis of the thoracic spine. Scoliosis of the thoracic spine - treatment. Scoliosis of the thoracic spine - symptoms

Scoliosis refers to the deformation of the spine, in which its lateral curvature and simultaneous rotation of the vertebral bodies develop. As a rule, this disease is diagnosed in childhood. With the growth of the child, scoliosis can progress. Pathological changes become more pronounced.

Quite often this disease is confused with a violation of posture, when there is a curvature of the spine, but the bodies of the vertebrae do not change their position. To expose this diagnosis, such violations are mandatory.

It should be noted that scoliosis of the cervico-thoracic spine can develop , as well as a curvature in the chest, lower back and sacrum.

Etiology

In 80% of cases the causes of the disease remain unknown, therefore, they speak of idiopathic scoliosis. If we indicate the etiological factors that lead to an innate curvature, the following should be mentioned:

• fusion of the vertebrae;

• fusion of the ribs (at the same time scoliosis of the thoracic spine develops);

• the presence of underdeveloped vertebrae, the wrong development of their processes and arches (such pathological changes lead to the fact that the spinal column develops asymmetrically).

The causes and types of acquired scoliosis

As a result of the action of factors that affect the body from the outside, the curvature of the spine develops, which is diagnosed after birth.

The following types of congenital scoliosis can be distinguished:

1. Neurogenic - occurs with lesions of the nervous system. Develops after poliomyelitis, dystrophic spinal cord injury, in children's cerebral palsy or myopathy. These diseases cause paralysis of the motor nerves. This leads to a disruption of the muscles that support the correct position of the body.

2. Ricky - is observed with a lack of vitamin D, characterized by muscle hypotension, deformation of bones, osteoporosis.

3. Static - is associated with the deformation of the legs, when the pelvis is placed in the wrong space, which leads to deformations of the entire spine.

4. Idiopathic - usually diagnosed in children after 10 years.

Scoliosis of the thoracic spine: severity

Normally, the spine has physiological curves, as a result of which it resembles the letter S. In scoliosis, there are curvatures of the spine of different sizes. The greater the angle of displacement from the main axis, the more difficult this pathology can be corrected.

In most cases, a right-sided scoliosis of the thoracic spine is diagnosed. Depending on the angle of curvature, these degrees of severity are distinguished:

• light - the angle of curvature reaches no more than 10 °;

• medium severity - this indicator is 10-25 °;

• heavy - the curvature can reach 50 °;

• Very heavy - characterized by deformation of the ribs and angle of curvature, which is more than 50 °.

It should be noted that at the beginning of the disease you can see only one bend of the spine to the side, but later another one is formed, which is localized below the first, but is directed in the opposite direction. Left-sided scoliosis of the thoracic spine has no fundamental differences (the difference is only in the direction of the scoliotic arch).

Manifestations of cervicothoracic curvature of the spine

This scoliosis is also called the upper thoracic spine. This form of the disease is characterized by the fact that the primary arc of curvature is short and steep, and the secondary arc is rather sloping and long.

It should be noted that such scoliosis is rare, but has a characteristic clinical picture, which is associated with involvement in the pathological process of not only the cervical vertebrae, but also the bones of the facial skull.

Upon examination, the doctor may notice a sharp squeezing, asymmetric placement of the eyes or oblique localization of the nose. In addition, the deformities of the upper chest and upper arms are diagnosed. The neck of the patient looks shortened, the edge of its trapezius muscle abruptly protrudes, which is difficult to correct, especially with the late onset of therapy.

With severe deformation of the chest and thoracic vertebrae, there is talk of thoracic scoliosis. It is important to identify this pathology by the time the formation of the spine is completed (by the age of 20-21 years). Otherwise, treatment may be hopeless.

Thoracic Scoliosis Clinic

This disease can be detected by evaluating the data that is obtained when examining the patient. So, if there is scoliosis of the thoracic spine, you can visually notice the curved to the side of the spinal column, asymmetric placement of the shoulders, upward-scaped shoulder blades, and also the protruding abdomen due to a violation of posture.

In addition to visual symptoms, thoracic scoliosis is characterized by certain complaints from the patient. As a rule, people with such a curvature of the spine note unpleasant sensations in the chest and pain in the area between the scapula, which can be explained by the infringement of the nerve processes. In severe cases, patients have abnormalities in the work of the respiratory system, the heart.

With further progressing, both left-sided and right-sided scoliosis of the thoracic spine leads to anatomical abnormalities in the structure of not only the thoracic but also the abdominal cavity, which is accompanied by pathological changes in the digestive organs.

Diagnostics

Scoliosis of the thoracic spine, the symptoms of which may be mild, requires attention of doctors, because the therapy of such disorders from the skeleton is more effective in the early treatment of medical care.

In the early stages of the disease, fluoroscopy in two projections allows not only to confirm the presence of scoliosis, but also to determine the most optimal methods of treatment. It should be remembered that with the curvature of the spine may be associated with serious illness. Incorrect distribution of body weight in scoliosis leads to degenerative changes in the vertebrae, dorsopathy of the spine, as well as to osteochondrosis and intervertebral hernia.

Scoliosis can also be diagnosed with the naked eye. When viewed, the different height of the shoulders is noticeable, as well as the curved vertebral line, which becomes even more noticeable if the patient leans forward.

If you are wondering what the scoliosis of the thoracic spine looks like, the photo of this pathology is presented below.

Treatment of scoliosis

The success of therapy depends on timely diagnosis. The faster this pathology is detected, the greater the chance of obtaining positive results.

It should be noted that for each patient an individual plan of therapeutic measures is prepared. In this case, the stage of the disease and the peculiarities of its course are taken into account. As a rule, when the scoliosis of the thoracic spine is diagnosed, the treatment is carried out in three stages:

• direct influence on the departments of the spinal column, in which lateral curvature was found;

• procedures aimed at correcting scoliosis;

• fixing the correct position of the spine after treatment.

It should be noted that the most difficult is the last stage. Patients do not give him due attention, so scoliosis develops repeatedly. That is why it's important to comply with all the prescriptions of the doctor, develop the back muscles and carry out posture correction. Therapy should be comprehensive and include conservative methods of treatment, and if necessary - surgical intervention.

Physiotherapy

One of the main conservative therapeutic methods is exercise therapy. Especially effective is a specially developed complex of exercises, which in childhood has not only rehabilitation, but also therapeutic effect. Its main goal is to reduce the burden on the spine, eliminate muscle imbalance, strengthen the ligament apparatus and form a correct posture.

As a rule, it is recommended to perform exercises that strengthen the group of muscles supporting the spinal column, and also have a corrective effect on its curvature, improve the function of external respiration, and exert a restorative effect on the body.

Most often recommend the following types of exercises:

• lie on your back, bending your knees, raise your pelvis, bending in the thoracic area;

• a positive effect is caused by hanging on the crossbar, at which the trunk is slowly turning to the sides;

• lie on the abdomen and lift the trunk so that the thoracic spine bends;

• that the curvature does not progress, it is necessary to attach a stick at the level of the shoulders, grab it with your hands and walk with it every day for 2 hours each;

• The exercise "bicycle" also has a positive effect on the curvature of the spine.

When there is scoliosis of the thoracic spine, exercises should be performed at a slow pace. After classes it is useful to rest for 20 minutes, lying on its side.

Patients, in addition to exercise therapy, are also recommended to wear special corsets, to go swimming.

Massage

At once it is necessary to tell, that in cases when the patient suffers a scoliosis long enough, and in a backbone there are the expressed pathological changes, massage will not give positive result. As a rule, it is prescribed at 1 or 2 degrees of curvature. Massage is performed in a polyclinic or in a hospital. The complex of exercises is selected individually depending on the form and severity of the disease, appointing it every 6 months.

When a scoliosis of the thoracic spine is detected, massage is carried out with a mandatory consideration of the direction of deformation. Since on one side of the scoliotic arches the muscles are in constant tonus, the masseur uses techniques that promote relaxation. On the other side, the muscle fibers are stretched and weakened, so we need a massage technique that would lead them to tone and strengthen.

It should be noted that self-massage in scoliosis is contraindicated, since an incorrect tactic of its conduct may provoke an increase in deformation and worsen the patient's condition.

Operative treatment of scoliosis

Despite the high level of modern medicine, severe forms of scoliosis are difficult to correct. The most effective treatment is the use of implants from metal.

Operative intervention is carried out by two methods:

1. Anterior mobilization of the spine (or multi-level discectomy with simultaneous correction of deformation). Such a surgical procedure is performed under general anesthesia. The most optimal results after the operation are a decrease in the angle of the scoliotic arch from 30 to 54 °.

2. Galpelviktraktsiya in conjunction with the correction of deformations. This surgery is even more effective and helps to reduce the angle of the spinal bend to 22 °.

When a scoliosis of the thoracic spine is diagnosed, surgical treatment always reduces the costal hump. This is due to the fact that after the operation the intercostal space expands, and the deformation decreases.

The most difficult is the surgical treatment of scoliosis among children, because their spine is constantly growing, and the use of metal structures can lead to a "crankshaft" syndrome. That is why in the treatment of scoliosis in childhood, special dynamic designs are used, which can be increased as the patient grows.