diagnosis of scoliosis
Physician during the examination notes different horizontal shoulder level, curvature of the spine, towering on the one hand or shoulder rib reinforced asymmetrical bending waist, different horizontal level of the iliac bones protruding hip. Test scores in the slope at which the normal spine is almost flat, and is noted for scoliosis arc aside. The degree of curvature of the spine is measured using an X-ray of the whole spine standing. Just for an X-ray can see the anomalies of the vertebrae.
Scoliosis should be divided into structural and functional
-In the case of structural scoliosis occurs deformation of the vertebral bodies, and with the progression and ribs, chest and pelvis. In view of the curvature of the spine stable.
-In the case of functional scoliosis should not say more about scoliosis and scoliosis of the adaptive posture without deformation of the vertebral bodies. When troubleshooting a pathological factor scoliotic posture may regress.
Causes of scoliosis (structural)
1 – scoliosis myopathic origin.
2 – scoliosis neurogenic origin.
3 – dysplastic scoliosis.
4 – scar scoliosis.
5 – traumatic scoliosis
6 – idiopathic scoliosis (or poorly understood, or have a genetic predisposition).
Severity scoliosis deformation is divided into four degrees:
• Scoliosis 1 characterized by a small degree of lateral deviation (up to 10 °) and initial mild twisting detectable on radiographs.
• Scoliosis 2 degrees is characterized not only noticeable deviation of the spine in the frontal plane ¬ but pronounced twist on ¬ lichiem compensatory arcs. The X-ray snim ¬ ke clearly manifested deformation of the vertebral bodies at the level of the top of the curve. Angle of the primary arc of curvature in the range of 11 ° -25 °.
• Scoliosis grade 3 – persistent and severe form of spinal deformity, the presence of costal mountains ¬ ba, significant deformity of the chest. Primary angle ¬ Noah arc of curvature within 26 ° -50 °.
• Scoliosis 4 degrees accompanied by severe bending of the trunk. Marked kyphoscoliosis of the thoracic spine, fixed deformity of the chest, back and front rib hump deformity of the pelvis, torso deviation. The angle of curvature of the core reaches 50 °.
Osteopathic view of the origin of scoliosis:
1) Neurological origin (idiopathic): difficult amenable to correction; orthopedic, surgical approach and osteopathic treatment should complement each other.
2) vertebral origin: if not traumatic deformation, it lends itself well to correction in children using osteopathic treatment and optimization of static and dynamic loads.
3) Cranial origin. Tensioned membrane of the brain inside the skull between the bones, providing the brain suspensory ligament system. Dura is stretched between the occipital bone and the sacrum. When cranial dysfunctions in response to twisting membranes and bones of the skull changes the balance of tone throughout the musculo-skeletal system, violated fascial traction in the body. As a result, formed “patterns”-disadaptative load distribution models and the human motor stereotype. In the treatment should focus on the cranio-sacral therapy.
4) visceral origin – it is important to consider the impact on the balance of the internal organs and muscle tone fascial structures may reflex muscle imbalance. In visceral scoliosis can help in childhood and early adolescence.
5) the same type, repetitive asymmetrical static and dynamic loads. 6) from the Pathology lower extremities. Contribute to the curvature of the spine, orthopedic abnormalities, flat, different leg length, pelvic asymmetry, disease of the hip joints.
7) Consequences of surgical treatment gives a prerequisite for “twisting” of the tissues around the scar. 8) Injuries to the spinal column.
9) Birth injuries. In the form of scoliosis can occur in subsequent vertebral compression fractures, subluxations, damaged muscles.
Scoliosis treatment can be conservative (allopathic and osteopathic approaches) and surgically.
1) allopathic approach
Conservative treatment of scoliosis is to use specialized medical gymnastics antiskolioznoy by Schroth and korsetoterapiyu principle Abbott-Chenault.
Scoliosis treated more than 20-25 ° derotiruyuschim corset and intensive medical gymnastics.
In some cases, teens can achieve scoliosis correction using conservative treatment, which depends on the degree of curvature of the spine, the patient’s age, genetic predisposition. In other cases, adolescents not stop the progression of scoliosis.
Disadvantages korsetoterapii abuse – with prolonged use of the corset muscle tone decreases and there is untrained muscles.
At the age of 20-25 years after scoliosis formed when conservative measures are not effective, but it can help the body to be more adapted to the current situation (despite the presence of scoliosis, if help the body to adapt, the scoliosis will not cause complaints). For some patients in their teens, it is important not so much to align emerging scoliosis, how to stop its progression, without orthopedic treatment and compliance regime is not feasible.
2) Osteopathic approach
The purpose of the osteopathic approach – addressing the causes of scoliosis, back-up systems to stimulate adaptation, gradual “self” (self-regulation) correcting body posture.
Elimination of external pathogenic factors, the correction effects of birth trauma – an essential condition for the effective treatment of scoliosis.
Osteopath in fact “does not cure, but allows treatment is finished.” Adequate approach that osteopath, not impose their vision of the patient correct posture. The patient’s body itself chooses the most optimal way to adapt and heal. Osteopath only “fulcrum” for the patient’s body.
Grade 3 and 4 scoliosis any recalcitrant to conservative treatment. Under the influence of these degrees of scoliosis on the internal organs may discuss surgery.
Osteopathy can not really change the posture, 3 and 4 degrees of scoliosis (especially after 20 years), but it can help to harmonize the body and help the body adapt to the situation in which the patient is here and now.
In order to get the best effect of osteopathic treatment for scoliosis, you need to seek medical help as soon as possible, when the first signs of the disease in childhood and adolescence.
Should take into account the relevance and interaction orthodontist osteopath in the treatment and prevention of cranial dysfunctions as important an adequate selection ortoezov footsteps ascending to correct dysfunctions.
The difference between allopathy and osteopathy in treating scoliosis
Classical (allopathic) medicine through their representatives: neurologists, orthopedists and surgeons faced with scoliosis, sees only two problems: curvature of the spine and the concomitant pain. Osteopath finds a lot of subtleties that are deep and meaningful causes of back problems.
Specificity of osteopathy – the ability to see all the causal relationships, considering the body as a whole system. This allows you to remove the original cause of pathology.
Indications for surgical treatment depends on the degree of scoliosis, severe scoliosis influence on the internal organs, the age of the patient and psychological problems (angle of curvature between 45 ° and 70 ° Cobb, ie scoliosis 3-4 tbsp.) if all possibilities have been exhausted, and conservative treatment is not effective.
When too late to start (teenage) idiopathic scoliosis surgery is usually not indicated.
The surgical treatment using metal rod straightens the spine, which leads to the immobilization of the spinal segment (it violates the biomechanics of the spine and is not quite optimal). Internal fixation can prevent further progression and deterioration.