Kifoscoliosis is a pathological deformation of the spine, which involves simultaneous curvature in the sagittal and frontal planes. This pathology combines at once two diseases: kyphosis - pathological bending back in the thoracic region and scoliosis - curvature of the spinal column to the side( to the right or to the left).The disease can be both congenital and acquired, appearing in children and adults. Representatives of the male suffer from this deformation 4 times more often.
Kifoscoliosis leads to impaired posture, rapid fatigue, physical fatigue, chronic back pain, and with severe curvature a significant cosmetic defect appears, and the functions of the internal organs begin to suffer.
The healthy spine of an adult has several physiological curves in the frontal plane( cervical and lumbar lordosis, thoracic kyphosis).They are formed, starting from childhood, and provide compensation of axial loads during movements. Side bends of the spine normally does not. The vertebral column after 20-25 years is not so plastic, so the bulk of the disorders of posture are in children and adolescence.
Incorrect posture at the desk can trigger the development of kyphoscoliosis
Kifoskolioz develops gradually. As a rule, first there is kyphosis, to which scoliosis joins in the near future, if not to take any preventive measures and do not perform therapeutic exercises.
Depending on the cause of the deformation, two groups of kyphoscoliosis are distinguished:
Congenital forms can be associated with defects in fetal development of the fetus, with some hereditary diseases. Most often, these deformations are caused by anomalies in the development of individual vertebrae, for example, superfluous or missing, underdevelopment of individual vertebral elements, their irregular shape or size.
It's important to remember! Most often, congenital kyphoscoliosis is diagnosed at the age of a child older than 6 months. Since it is during this period that the baby begins to sit, and in the future to walk, and the spinal curves are formed.
Acquired kyphoscoliosis can have many causes and develop in different periods of life, but most often it is the older child and adolescence.
Factors that can cause the acquired deformation form:
- connective tissue diseases( dysplastic kyphoscoliosis);
- transferred to childhood rickets;
- tumor lesions of the vertebrae;
- consequences of poliomyelitis;
- infantile cerebral palsy;
- lesions of muscle tissue( myopathy, myodystrophy);
- constants of spinal congestion;
- physical inactivity;
- incorrect posture at work, study;
- the presence of imbalance in some children during the period of active growth between increased bone mass and muscle mass;
- traumatic injuries;
- operations on the spine;
In the case when it is not possible to establish the cause of the curvature, it is an idiopathic kyphoscoliosis. According to the international classification of diseases 10 revision( ICD 10), kyphoscoliosis has the code M41.
Degrees of kyphoscoliosis
Specialists distinguish 4 degrees of this type of curvature of the spine:
- Kifoscoliosis 1 degree : the angle of deflection back is 45-55º( normal to 45º), the lateral curvature is minimal.
- Kifoskolioz 2 degrees is diagnosed in the presence of a curvature angle of 55-65 degrees, scoliosis becomes more pronounced, axial twisting of the vertebrae develops.
- Kyphoscoliosis of the 3rd degree : the angle of deflection increases to 65-75º, the hump on the back begins to form, the curvature to the side is well pronounced, the vertebrae are twisted along the vertical axis.
- 4 degree of deformation is established on the presence of kyphosis more than 75º, the curvature in the side is expressed maximally, the spine is severely deformed, the internal organs are squeezed, which disrupts their activity.
Depending on the direction in which the arc of scoliosis is open, the left-sided and right-sided kyphoscoliosis are distinguished. This is important for selecting a set of therapeutic exercises.
Curvature of the 4th degree can only be corrected surgically
Congenital deformity begins to appear at the age of the child 6-10 months, but there are cases when at birth there is a curvature corresponding to 3-4 stages. Deformation with the growth of the child is progressing. The shoulder blades are asymmetrical, one shoulder is lower than the other, a muscular roller is seen on the back.
In addition to signs of scoliosis, there are symptoms of kyphosis: on the back you can see protruding spinous processes of the vertebrae, stoop, head lowered, bulging belly.
In case of presence of the 3rd and 4th stage of the disease, the function of the internal organs starts to suffer: the heart, lungs, digestive organs - and complaints appear. Also, patients are worried about chronic back pain, inability to stay in a horizontal position for a long time, and reduced tolerance to physical exertion.
When the spinal roots or the spinal cord is compressed, neurological symptoms appear: paresis and paralysis of the limbs, impaired sensation, and pelvic organs.
As a rule, acquired kyphoscoliosis has a more favorable course. The deformation develops not so fast, that gives time for the treatment of kyphoscoliosis. The main complaint in such cases is stoop, impaired posture, back pain. Acquired forms of the disease rarely reach the 3rd and 4th degree of curvature.
Congenital kyphoscoliosis of the 4th degree in the child
Complications and prognosis
Because of the pathological form of the spine, the load on it and all other axial joints( knee, hip, ankle) is not distributed correctly, which leads to an increased risk of degenerative-dystrophic diseases of the joints and spine. Such patients are prone to early development of osteochondrosis, which is complicated by multiple intervertebral hernias;to deforming osteoarthritis. These diseases further aggravate the condition and contribute to the progression of the curvature of the spinal column.
In case of severe deformity, the internal organs are affected. Such patients are prone to respiratory and heart failure, they often develop arrhythmias, pneumonia. Also, the function of the digestive system suffers, reflux disease develops, dyskinetic disorders of the gallbladder and intestine.
When the spine is deformed, the internal organs of
are disrupted. The age at which the kyphoscoliosis is diagnosed, as well as its form( congenital or acquired) and degree is an important point in making the prediction. If the pathology is established up to 14-15 years, the chances of a complete cure are very high. If kifoskolioz 1-st - 2-nd degree, then get rid of it will help conservative therapy techniques( exercises, massage, physiotherapy, stretching, etc.).If the curvature has reached the 3rd - 4th degree, then only the operation will help to correct the posture completely.
Service in the army
Passage of service in the army of a patient with kyphoscoliosis is completely dependent on the degree of curvature of the spine, that is, the stage of the disease:
- , at the 4th degree, the draftee is considered unfit for military service with expulsion;
- at the third degree - is not suitable in peacetime and is limited in military service;
- at the 2nd degree - can be either unfit in peacetime or limited to fit( depends on the degree of curvature of the spine);
- at the 1st degree - is valid with insignificant restrictions.
To establish the diagnosis, you need an examination by an orthopedic physician and an x-ray examination of the spine in 2 projections with the determination of the angle of deviation in anteroposterior direction and lateral.
Radiography is the main method for diagnosing and determining the degree of kyphoscoliosis
In severe diagnostic cases, the doctor may prescribe an MRI or CT scan of the spine. It is also necessary to consult a neurologist and other narrow specialists, depending on the symptoms present( cardiologist, pulmonologist, gastroenterologist).
Treatment of kyphoscoliosis depends on the stage of the disease and can be conservative and surgical.
As a rule, the 1st and 2nd stages of deformation are treated only conservatively. Therapy should be comprehensive, regular and lengthy. Only in this case it will be possible to stop the pathological process and establish a posture.
Therapeutic gymnastics allows not only to get rid of posture disorders, but also to warn them
. The complex of medical measures can include:
- exercise therapy complex .Medical gymnastics is the main method of prevention of kyphoscoliosis and a means of getting rid of it. Exercises should be selected only by a specialist, taking into account the type of curvature and its degree. They allow you to strengthen the muscular corset back, relax the necessary muscle groups. The key to success is regular classes.
- The is crosstalked. Mechanical correction of the posture with the help of individual corsets, recliners is a rather effective method of therapy if the orthopedic product is correctly selected and the patient correctly wears it.
- Physiotherapy .They help to reduce back pain, improve microcirculation and nutrition of tissues, and remove pathological muscle spasms.
- Massage of the .Assign to make the muscles plastic, remove their tension, improve blood and lymph circulation.
- Drug Therapy .It is prescribed only with exacerbation of the pain syndrome in short courses. After acute pain is eliminated, the methods of therapy described above are immediately started.
Operation in kyphoscoliosis is prescribed in exceptional cases:
- 4th degree of deformity;
- pronounced pain syndrome, which can not be removed with the help of conservative methods;
- neurologic complications that progress;
- disrupting the work of internal organs, threatening health and life;
- in some cases, the operation can be performed according to cosmetic indications.
It is important to remember that the success of an operation is more than half dependent on the rehabilitation period, which is very long and complicated. Therefore, it is necessary to treat kyphoscoliosis at an early stage. Thus, it will be possible to correct the posture without problems and prevent complications, and not to fight them later.
- Reasons for
- Degrees of kyphoscoliosis
- Symptoms of
- Complications and prediction
- Service in the army
- Treatment methods