Kyphosis of the thoracic spine
Kyphosis of the thoracic spine is its curvature in the anterior-posterior plane. Curvature can be both pathological and physiological. In the thoracic region, kyphosis develops most often, although cases of the formation of both cervical and lumbar kyphosis are described in the medical literature.
The disease manifests itself mainly in pain that occurs in the place where the curvature occurred. Many factors lead to kyphosis, including: hereditary predisposition, trauma, improper posture taken by a person during work or study, weakness of the back muscles, etc. Kyphosis, as a rule, does not pose a threat to a person's life and is treated conservatively, but surgical intervention is not excluded …
Physiological kyphosis of the thoracic spine is present in all people. They talk about pathology when the bend exceeds an angle of 45 ° C. Kyphosis is often combined with spinal scoliosis.
Statistics indicate that up to 10% of people around the world live with some degree of kyphosis. Male children and adolescents are more susceptible to it.
It is interesting that in ancient times people with a hump were treated as representatives of an evil force and were often afraid of them. However, now there is no doubt that there is nothing mythical about this disease.
- Symptoms of kyphosis of the thoracic spine
- Causes of kyphosis of the thoracic spine
- Diagnostics of the kyphosis of the thoracic spine
- Treatment of kyphosis of the thoracic spine
Symptoms of kyphosis of the thoracic spine
It is a mistake to believe that the symptoms of kyphosis of the thoracic spine are manifested only in the stoop or the presence of a hump.
In the body, due to the curvature of the spine, changes invisible to the eye will occur:
- The volume of the chest becomes less lung capacity, which does not allow the patient to take a full breath.
- The diaphragm gradually drops down and begins to press on the internal organs, which leads to disruption of their work.
- As the kyphosis progresses, the patient develops compensatory hyperlordosis in the lumbar and cervical regions.
- The height of the intervertebral discs decreases at a faster rate, compared to how it would occur during natural aging of the body. The amortization capacity of the discs suffers.
- Pinching the roots of the spinal cord leads to disruption of the innervation of the upper and lower extremities.
- The redistribution of the load on the intervertebral discs becomes the impetus for the development of osteochondrosis.
Objective complaints presented by patients with thoracic kyphosis:
- Rapid fatigability of the back muscles;
- Upper back pain;
- Numbness and weakness of hands, feeling of "goose bumps" on the skin;
- From the digestive tract - lack of appetite, belching, stool incontinence, or constipation;
- On the part of the respiratory system - shortness of breath, increased frequency of bronchitis, which differ in the severity of the course and can end with pneumonia;
- Disturbances in the work of the cardiovascular system - an increase in blood pressure, tachycardia.
Depending on the nature of the thoracic kyphosis, the appearance of a person changes. So, with angular kyphosis, a hump appears, the body becomes shorter, the chest is protruded forward. With arcuate kyphosis, the entire thoracic spine is deformed, the patient's back takes the shape of the letter C.
Causes of kyphosis of the thoracic spine
The causes of kyphosis of the thoracic spine are multiple, among them:
- Disorders of intrauterine development that occur at the stage of formation of the vertebrae in the embryo. In 13% of cases, kyphosis is combined with other anomalies in the development of the spine, when cysts, constrictions, abnormal spinal roots, etc. are found in the child.
- Poor heredity (Scheuermann-Mau disease).
- Past injuries are the most common causes of thoracic kyphosis. The risk of developing the disease directly depends on how severe the injury was.
- Paralytic kyphosis is formed as a result of paresis and paralysis of the spinal muscles in cerebral palsy and poliomyelitis.
- Surgical interventions on the spinal column.
- Physical inactivity.
- Compression fractures of the thoracic vertebrae, which are often observed in old age, mainly in women.
- Non-infectious diseases (spinal tumors, ankylosing spondylitis, spondylitis).
- Radiation therapy to get rid of malignant neoplasms. In this case, children are at risk. In adults, after such irradiation, kyphosis does not develop.
- Poor development of the back muscles.
- Rickets, transferred in childhood.
- Incorrect body position during study or work.
- Psychological factors. For example, the disease can develop as a result of the fact that a teenager is embarrassed about his height and deliberately slouching.
- Degenerative changes in the spinal column due to osteochondrosis and osteoporosis.
Diagnostics of the kyphosis of the thoracic spine
Diagnosis of kyphosis of the thoracic spine is in the competence of an orthopedic surgeon. To begin with, the patient is interviewed, after which the doctor examines him. It is important to clarify the features of pain, their localization, the presence of neurological disorders. During the examination, the orthopedist palpates the neck and back, specifying muscle strength and skin sensitivity. In addition, the doctor listens to the heart rate and lungs, evaluates the tendon reflexes using a specialized set of tests.
The next stage of the study is an X-ray of the spine. Most often it is performed in several projections (frontal and lateral), as well as sighting shots are taken in non-standard projections, for example, during stretching of the spine.
If there is a suspicion of pathological changes in soft tissues, then the patient is shown an MRI scan. Computed tomography is performed to clarify certain disorders of the bone structures.
Treatment of kyphosis of the thoracic spine
Treatment of kyphosis of the thoracic spine is most often conservative. The patient is recommended to perform exercise therapy, which allows you to strengthen the muscles of the back, visit a massage and physiotherapy room. Sometimes the help of a chiropractor is required. Corsets are selected individually, they are more designed to reduce pain. You should not wear a corset regularly, since these devices will not help correct your posture, but you can weaken your back muscles in a state. This, in turn, will lead to the progression of the disease.
Implementation of the exercise therapy complex
A correctly selected complex of physiotherapy exercises can completely save a person from the disease. Exercise is especially effective in childhood, until the spine has finished its growth and formation.
However, adults should not ignore treatment complexes. Through regular exercise, you can strengthen your back muscles, normalize blood circulation, and stop the progression of the disease.
There are many sets of exercises. It is better if they are compiled by the attending physician individually, depending on the angle of inclination of the kyphosis, on the age of the patient, on the presence of concomitant diseases. In addition, it is important to eliminate the immediate cause that led to the curvature of the spinal column.
Massage for the treatment of thoracic kyphosis
The massage will be effective if combined with gymnastic complexes. It should be performed by a professional. If there is no opportunity to visit the massage room, then it is important that the technique of its implementation is strictly observed. This will allow not to harm the patient and worsen the course of kyphosis.
You must be guided by the following rules:
- Movements should be light, smooth.
- Your back muscles should be relaxed. The position that the patient takes should be chosen as comfortable as possible.
- You should not put strong pressure on the curved area of the spine.
- The back skin must not be damaged.
- Carefully massage those vertebrae that stick out from the skin.
Surgical treatment of the disease
Surgical intervention is carried out for the following indications:
- Pain that is not controlled by drug therapy and other conservative methods.
- Accelerated progression of kyphosis, combined with neurological disorders.
- Kyphosis affects the function of the heart and lungs.
- Kyphosis is a cosmetic defect that impairs a person's quality of life and interferes with work.
There are also contraindications to surgery, including:
- Senile age.
- Arterial hypertension of the third stage, arrhythmia, diabetes mellitus and other diseases.
- Oncological diseases.
The challenge facing the surgeon is to correct the angle of inclination of the spinal column and to stop the progression of the disease. It is important to eliminate the clamping of the nerve endings, as well as to prevent their compression in the future. Surgery on the spinal column is difficult and requires high qualifications on the part of the doctor. It is imperative to perform general anesthesia and thorough preliminary preparation of the patient. Often one operation cannot be done.
A wide variety of structures are used to fix the spine in the desired position. Modern materials are titanium and titanium nickelide. The prostheses made of them are not rejected by the body and for many years can be in it without any consequences.
There are two methods by which surgery is performed:
- Osteotomy with bone transection and further plasty. During the operation, the curved vertebrae are cut, the existing deformities are corrected, and then they are fixed in the correct position. The cracks that form as a result of the repair of the vertebrae are filled with various materials. This can be bone from donors, artificial grafts, or biological fluids. The final stage of the operation is the fixation of the spinal column with titanium screws or other structures. This method is highly effective for severe kyphosis of the thoracic spine.
Less invasive operations include kyphoplasty. The procedure for restoring a destroyed vertebra is performed through small incisions that are made at the site of damage. All manipulations are performed using endoscopic equipment. In the place where the destroyed vertebra is located, the surgeon inserts a capsule, which inflates and takes the form of a defect. Then the capsule is filled with a special hardening solution. This allows you to create a structure that will prevent the spine from collapsing. This operation will be effective for minor injuries of the spinal column, as well as for recent injuries.
Prevention of kyphosis consists of posture control. The posture while working at the computer, while studying at school, when doing homework, must be correct. If parents notice that their child has begun to slouch, then this is a reason to contact an orthopedist.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".