Scoliosis grade 4: treatment methods
Changes in the human body with the transition of scoliosis to grade 4 are most often irreversible and lead to disability. This is an extremely severe lesion of the spine that deforms the spinal cord and internal organs. Compensatory syndrome disrupts the normal functioning of the dorsal muscles that tighten the spine towards deformity.
This is the most difficult pathology of the spine for correction, in which, in addition to the spinal column, curved in the frontal plane, the chest, lumbar region, and pelvic bones are deformed. The asymmetry of the torso is visible to the naked eye, even to a non-specialist. In this case, the ribs protrude back and forth, a person loses coordination of movements, awkwardly waddles from foot to foot when walking. The patient develops a scoliotic hump, two oppositely directed arcs form on the spine.
The situation is aggravated by spasmodic muscles that stretch the spine in the opposite direction. These spasms are due to the fact that the roots of the nerve endings of the spinal cord are pinched by the vertebrae. The pathological process affects the blood circulation of the spinal cord, the accurate transmission of nerve impulses. Due to the displacement of the internal organs, the violation of their innervation, the functioning of the support systems of the human body is carried out intermittently.
Due to the excessively deformed chest, serious pathologies appear in the work of the respiratory and cardiovascular systems. Due to the bending of the spinal column, the functioning of the organs, the work of which is regulated by the lower parts of the spinal cord, is disrupted.
Content:
- Causes of scoliosis grade 4
- Grade 4 scoliosis symptoms and complications
- Grade 4 scoliosis treatment
Causes of scoliosis grade 4
Scoliosis of the 4th degree is based on spinal injuries and posture disorders that appeared at the age of 6-12 years. The bone tissue of the child's vertebrae is quite plastic, because it contains a lot of organic matter. At the end of osteogenesis (8-12 years), organic matter in bones and cartilage is replaced by phosphates, making them strong. If at this age you do not pay attention to the child's posture while doing writing, sitting at the computer, in front of the TV, the child will develop scoliosis.
When a vertebra is dislocated or spun out during trauma, scoliosis becomes a distant consequence of spinal cord injury. These reasons, which arose in childhood, become prerequisites for severe spinal lesions in adults.
Additional risk factors:
- Weakness of the back muscles, with difficulty supporting the spine in an upright position;
- A sedentary lifestyle that negatively affects the production of joint fluid, leading to rapid wear of cartilage and bones;
- Chronic pathologies that destroy bone and articular tissue (herniated disc, osteochondrosis);
- Narrowly directed load on any part of the spine during sleep, physical overstrain, deforming the spinal column.
Grade 4 scoliosis symptoms and complications
The main symptom of the fourth degree of the disease is that the angle of deviation of the spinal column from the norm is more than 50 °.
Other manifestations of scoliosis:
- Curvature of the spinal column in 2 directions, as a result of which it takes an S-shaped, or Z-shaped;
- Different levels of the pelvic bones, shoulders, shoulder blades on the right and left sides;
- Different lengths of arms and legs due to the displacement of their attachment point;
- Loss of motor activity, violation of large and fine motor skills due to damage to the nerve fibers going to the limbs;
- Difficulty maintaining balance without support;
- Severe pain along the entire length of the spinal column due to pinching of the nerve endings by the vertebrae, aggravated by attempts to straighten up or change posture;
- Displacement of internal organs, disruption of their functioning;
- Spasms of the spinal muscles, leading to pathologies of the heart, lungs, organs of the gastrointestinal tract, genitourinary system;
- Respiratory distress due to a decrease in lung volume, chest deformation;
- Violation of cardiovascular activity due to an increase in the left atrium and ventricle, compression of the heart by the chest;
- Contact on one side of the lower ribs with the ilium of the pelvis;
- The appearance of a "duck" gait due to the shift in the center of gravity of the pelvis, the difference in the length of the legs.
The consequence of scoliosis of the fourth degree is stomach ulcer, cholecystitis, diseases of the urogenital tract, digestive organs and cardiovascular system. Women with a history of grade 4 scoliosis have difficulty conceiving and bearing a child.
When paralysis of the limbs, complete or partial immobility, uncontrolled defecation or urination occurs, the patient is assigned a group of disabilities.
Grade 4 scoliosis treatment
There is a strong opinion that it is impossible to cure grade 4 scoliosis with conservative methods. However, experts say that up to 24 years - the period of complete ossification of the skeleton, it is possible to achieve a decrease in the symptoms of the disease, its retraining to 3 degrees. To do this, you need to make a lot of effort, conducting treatment under the guidance of a highly qualified specialist.
Physiotherapy
This method can bring significant regression of the disease in the case of a low content of phosphate in the vertebrae, or with the flexibility of cartilage in children and adolescents. Excessive loads and activity should be avoided, because an incorrectly composed set of exercises, instead of good, will harm, aggravate the situation. The load on the back, on the shoulder girdle, jumping and squatting is prohibited.
To restore posture, the formation of a muscle corset with the help of static gymnastics will be of great benefit. Gymnastics plays an important role during rehabilitation after spinal surgery. Even with a brilliant result, weak muscles cannot keep the spine in the right position. The selection of corrective exercises is carried out by a rehabilitation therapist.
Exemplary exercises used in grade 4 scoliosis correction:
- Take aside and raise multidirectional legs and arms;
- Extend the arm from the side of the deformation;
- Throw outstretched arms overhead in a prone position;
- Raise multidirectional legs and arms to the sides, standing on all fours.
When correcting grade 4 scoliosis, asymmetric swimming using a foam block or an inflatable circle is very useful. In this case, opposite legs and arms are extended diagonally, and bent along the other diagonal. Then the position of the legs and arms changes.
Operative treatment
Most often, surgical treatment of grade 4 scoliosis is carried out in two stages. At the first stage, the intervertebral discs are removed at the apex of the pathologically formed arch. As a result of this intervention, the spine becomes plastic. After 7-8 days, the turn of the second stage begins.
The sequence of actions of neurosurgeons:
- The skin and muscles are dissected from the posterior approach along the entire length of the deformity.
- The back vertebrae are freed from soft tissue.
- At the apex of the arch, the joints between the vertebrae are dissected.
- Implants are installed, which are attached to the vertebrae using special screws.
- Under the control of the monitor, the spine is derotation - returning it to its normal position.
- The pulses passed through the electrodes on the patient's head must be perceived by the electrodes attached to his legs.
- After bringing the spine to its normal position, the structure is firmly fixed.
- Bone grafting is performed, forming a bone block on the spine from previously removed pieces of bone.
The risk of complications in such operations is extremely low, the technique for their implementation is well developed. As a result of the intervention, the patient can return to normal life, his internal organs are able to function normally. To consolidate the results, you will have to wear an orthopedic corset for some time, periodically reducing the time of wearing it as directed by the orthopedic surgeon.
Scoliosis of the fourth degree significantly worsens the patient's quality of life, disrupts the functioning of all body systems. If it is impossible to use conservative methods, surgical treatment is used.
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.
