Scoliosis 1 degree
Curvature of the spine in the frontal plane to the right or left relative to the axis is called scoliosis. According to the international classification of diseases 10 revision (ICD-10), this disease corresponds to the code M41 from the interval M00-M99 "Diseases of the musculoskeletal system and connective tissue".
This process affects all parts of the spine, therefore, with the development of the pathological process, the anterior and posterior strengthening of physiological bends, as well as twisting of the spinal column, join the curvature of the spine in the lateral direction. With the transition of scoliosis to the next stages of development of the disease, the bones of the pelvis and chest are deformed. These changes provoke disruption of the functioning of the pelvic organs, abdominal cavity and chest.
Sensitive periods for the development of the disease are periods of intensive growth of the child:
- 4-6 years old;
- 10-14 years old.
In adolescence, the disease develops intensively during puberty:
- 11-14 years old in boys;
- 10-13 years old in girls.
If by this age the child has 1 degree of scoliosis, confirmed by X-ray examination (up to 10 °), the scoliosis is aggravated at a high rate. It is necessary to differentiate between scoliosis and poor posture. If the posture can be corrected with the help of a set of specially selected exercises, the correct selection of furniture, and correction of the posture when sitting at the table, then scoliosis cannot be cured without the systematic use of therapeutic measures throughout the entire period of the patient's growth.
Content:
- Classification
- Reasons for the development of scoliosis 1 degree
- Grade 1 scoliosis symptoms
- Diagnostics
- Treatment of scoliosis 1 degree
Classification
Distinguish between structural and non-structural scoliosis. The difference between them is that in structural scoliosis, the curvature of the spine to the right or left is accompanied by persistent pathological displacement of the vertebrae.
Types of non-structural scoliosis:
- Postural - provoked by a violation of posture, is not diagnosed with an X-ray performed in a prone position, as well as when bending forward;
- Compensatory - arises from the shortening of one leg;
- Reflex - provoked by the patient being in a forced position for a long time in pain;
- Hysterical - arises from a mental disorder, is rare.
Types of structural scoliosis (according to the etiology of the disease):
- Myopathic - provoked by pathologies of the muscular system (progressive dystrophy, myopathy);
- Traumatic - occurs due to injury to the musculoskeletal system;
- Cicatricial - provoked by cicatricial processes of soft tissues;
- Neurogenic - caused by a complicated course of poliomyelitis, neurofibromatosis and other pathologies of the nervous system;
- Osteopathic - based on congenital anomalies of the spine;
- Metabolic - provoked by a violation of metabolic processes in the body, a deficiency of bone tissue components (rickets);
- Idiopathic - the cause of the development is unknown.
Classification by the time of onset of the first symptoms:
- Infantile - 1-2 years old;
- Juvenile - 4-6 years old;
- Teenage - 10-14 years old.
Classification by the shape of the curvature:
- C-shaped (only to the right or only to the left);
- S-shaped (both right and left);
- Z-shaped (has three bends, almost never occurs).
Classification by localization of the curvature top:
- Cervicothoracic;
- Chest;
- Thoracic-lumbar;
- Lumbar;
- Lumbosacral.
Also distinguish between progressive and non-progressive curvature of the spine.
Reasons for the development of scoliosis 1 degree
The primary development of the pathological process is based on the immaturity of all links of the musculoskeletal system, the uneven growth of the child. The first degree of scoliosis accounts for up to 40% in the overall structure of all cases of this disease. Most often it is diagnosed at 8-15 years old.
In addition to uneven growth, the causes of the initial stage of scoliosis can be congenital anomalies of the musculoskeletal system.
Primary scoliosis causes:
- Defects in the structure of the vertebrae;
- Consequences of cerebral palsy (cerebral palsy);
- Underdevelopment of muscles and connective tissue responsible for the natural position of the spine;
- Congenital defects of the bones of the pelvis and chest.
Causes of grade 1 secondary scoliosis and its rapid progression:
- Incorrect posture when sitting at the table - hunched over, tucking his leg under him, resting his head on his hand;
- A long pastime in an atypical position for physiology - in front of the computer, in front of the TV;
- Sedentary lifestyle, lack of physical activity;
- Excessive stress, sports with uneven muscle development;
- Carrying bags, backpacks on the same shoulder;
- Unstable shoes with uncomfortable last;
- Inappropriate furniture.
Tuberculosis of the bones of the spine, osteomyelitis, calcium metabolism disorders can lead to deformation of the spinal column. There are gender differences in the structure of children with scoliosis - girls suffer from scoliosis 4-7 times more often than boys.
Grade 1 scoliosis symptoms
Since scoliosis is most often asymptomatic at this stage, timely diagnosis is of great importance.
Manifestations of the first stage of the disease:
- The curvature becomes more noticeable when leaning forward;
- One shoulder is lower than the other;
- In a standing position, arms along the body, the distance from the elbow to the waist is not the same on different sides;
- The shoulder blades are asymmetrical - the angle of one of them protrudes, it is closer to the spinal column.
When these signs appear, the child should be shown to a pediatric orthopedist.
Clinical and radiological symptoms of grade 1 scoliosis (according to Chaklin's classification):
- Deformation angle up to 10 °;
- There is a stoop;
- The waist is asymmetrical"
- The head is down;
- The shoulders are at different heights;
- X-ray signs are slight torsion (rotation and incorrect fixation) of the vertebrae.
Diagnostics
To clarify the diagnosis, an in-depth examination of the child is carried out in various positions.
Standing measurements:
- Leg length;
- Limb joint mobility;
- Kyphosis (the amount of bend);
- Lumbar mobility;
- Symmetry of the waist triangles;
- The position of the shoulder blades, shoulders;
- Visual examination of the chest, lower back, pelvis, palpation of these areas of the body to assess deformation of the ribs, muscle tone, the presence or absence of muscle ridges.
In the "bending forward" position, the symmetry or asymmetry of the spinal column is measured.
Sitting measurements:
- The degree of lordosis;
- Dina of the spinal column;
- The presence or absence of deviations to the right or left;
- The relationship between the position of the pelvis and the position of the legs.
In the supine position, the doctor evaluates changes in the curvature of the arch of the spinal column, palpates the abdominal organs, abdominal muscles.
An instrumental diagnostic method for determining the symptoms of scoliosis is X-ray of the spine. It is carried out 1-2 times a year, first in a standing position, then in 2 projections (standing and lying).
Additional methods for examining the spine with low radiation exposure:
- three-dimensional ultrasound or contact sensory examination;
- Bunnell scoliometry;
- light-optical irradiation of the back profile;
- MRI of the spine.
Treatment of scoliosis 1 degree
In the initial stage of the disease, with the timely start of treatment, the prognosis of the disease is favorable, since it is possible to return the spine to its natural position, to avoid the progression of the disease. It is important that treatment measures begin until the patient is 20-22 years old, that is, the processes of formation of musculoskeletal structures have not ended. In adulthood, treatment will be much more difficult.
Treatment goal:
- Providing the spine and surrounding muscles with "building material" - nutrition, minerals;
- Normalization of the regeneration processes of muscles, cartilage and connective tissue;
- Restoration of blood supply to musculoskeletal structures;
- Strengthening the muscle frame.
To restore vertebral tissue at stage 1 of scoliosis, chondroprotectors, multivitamins, and general strengthening medicines are used. The main content of the course of treatment is massage, physiotherapy exercises.
Purpose of the massage:
- Tissue regeneration;
- Normalization of metabolism;
- Restoration of blood flow;
- Formation of a muscle ridge on the side opposite to the curvature;
- Prevention of muscle hypertonia.
For grade 1 scoliosis, massage courses of 8-10 sessions are recommended. The masseur performs stroking, rubbing, vibration movements.
A precisely selected complex of therapeutic exercises can restore the spine in a short time. After the instructions given by the exercise therapy doctor, you can do it at home. The frequency of gymnastics is 2-3 times a week. The dynamics of changes is monitored using ultrasound or X-ray examination.
Exercises included in the treatment complex:
- Moving around the room on all fours;
- Spinal traction while lying down;
- "scissors";
- Imitation of swimming breaststroke on the stomach and on the back;
- Circular movements with your hands.
With scoliosis of 1 degree, young men are subject to conscription with limited load. With careful implementation of the doctor's recommendations on the organization of nutrition and therapeutic exercises, you can get rid of the initial stage of spinal curvature.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
