Scoliosis grade 3: treatment methods
A curvature of the spine that has reached the third degree is visually very easy to notice. The spine, deformed to this level, disrupts the functioning of internal organs, the pathology is difficult to treat. Correction of scoliosis requires a balanced approach, a well-grounded program to restore the physiological curves of the spinal column. In children, grade 3 scoliosis is extremely rare due to age-related plasticity of the spine, which has not yet had time to ossify. It is most often diagnosed in adolescents and adults. The number of patients with grade 3 scoliosis reaches 20% of the total number of people suffering from spinal curvature.
Content:
- Features of grade 3 scoliosis
- Reasons for the progression of scoliosis
- Symptoms of scoliosis grade 3
- Disability in the third degree of scoliosis
- Grade 3 scoliosis treatment
Features of grade 3 scoliosis
At the third degree, the curvature of the spine reaches an angle of 25-50 ° from the physiological norm.
Manifestations of grade 3 scoliosis:
- Skewed shoulders;
- The formation of the rib hump;
- Modification of the chest;
- Preservation of the vertebrae in an unnatural wedge shape for them;
- Depletion of intervertebral discs due to excessive pressure on the injured side;
- The appearance of protrusions, intervertebral hernias;
- Infringement of nerve fibers by intervertebral hernias, leading to severe pain;
- Impaired coordination and damage to nerve fibers due to the strong bending of the spinal cord;
- Development of osteochondrosis;
- Increased risk of injury leading to fractures or spondylolisthesis, even as a result of minor injuries;
- Bringing the muscles into a state of compensation, which leads to spontaneous flexion of the trunk;
- Difficulty finding a sleeping position, fatigue when walking, frequent pain in the morning;
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Lung damage due to a decrease in chest volume;
- The development of congestive pneumonia due to a reduction in the number of breathing exercises;
- The development of ventricular hypertrophy and dystrophy due to changes in blood flow;
- Tachycardia and dystrophy of the right ventricle due to stretching of the aortic arch;
- Reflux or obstruction of the esophagus due to dysfunction;
- Disruption of the gastrointestinal tract.
The body tries to compensate for the curvature of the spine in the lower section, producing a curvature in the upper section in the opposite direction. This forced measure, although it partially aligns the spine, leads to the appearance of other pathological processes.
Reasons for the progression of scoliosis
Other things being equal, in different patients who came to the beginning of the study with the same degree of curvature of the spine, after some time, the degree of its deformity can be very different. So far, this phenomenon cannot be explained.
Possible reasons for the progression of scoliosis to grade 3:
- Injuries to the spine and its components (intervertebral discs, vessels, vertebrae);
- Disorders of mineral metabolism (especially calcium) due to pathologies of the endocrine glands;
- Frequent stay in a forced position;
- Incorrect distribution of the load when lifting it;
- Weakening of the tone of the back muscles;
- Bone loss in postmenopausal women;
- Injuries leading to a fracture of the femoral neck, shortening of the lower limb, displacement of the pelvic bones;
- History of epilepsy leading to abnormal activity of the back muscles;
- Intensive growth in adolescents.
When a person is in the wrong posture for a long time, his vertebrae adapt to this state. After returning to a physiologically correct position, all parts of the spine return to normal. If the pathological process repeats often, returning to the starting position becomes difficult, and then completely impossible.
Symptoms of scoliosis grade 3
Changes in the appearance of a person suffering from grade 3 scoliosis are noticeable with the naked eye. In addition to changes in appearance, internal deformations appear.
Signs of the third degree of scoliosis:
- Shoulders, shoulder blades, pelvic bones are located asymmetrically;
- The triangles created by the waist line and the arm line have different shapes and sizes;
- The mammary glands in women are located at different levels;
- A scapular hump is formed;
- The ribs on the side of the bulge of the arch bulge noticeably;
- Ribs in front of rib cage bulge and sink;
- The lower ribs on one side are in contact with the bones of the pelvis, which leads to its distortion and lameness due to the shortening of one leg;
- Twisting the spine around the axis provokes pain syndrome and wedge-shaped deformities of the vertebrae.
Due to the violation of blood supply and innervation, problems with blood pressure arise. The patient loses coordination of movements, it is difficult for him to move. Each change in posture brings him painful sensations due to pinching of the nerve roots by the vertebrae.
Disability in the third degree of scoliosis
The progression of the disease to the third degree is the reason for establishing a disability group. This decision is made by MSEC according to the following criteria:
- The presence of progressive or non-progressive forms of scoliosis;
- Determination of the degree of pathology according to the clinical picture of the disease and X-ray data;
- The presence of neurological disorders and disorders;
- The frequency of occurrence of pain syndrome;
- Assessment of cardiovascular and respiratory failure.
Most often, MSEC establishes the third, less often the second group of disability, draws up an individual rehabilitation program. The definition of the disability group does not depend on whether the patient underwent surgical treatment.
Grade 3 scoliosis treatment
With the third degree of scoliosis, the main method of treatment is surgery. Such conservative techniques as massage, physiotherapy exercises, wearing bandages and orthopedic corsets, physiotherapy, are auxiliary methods of scoliosis therapy. They are aimed at the formation of a muscle corset that supports the spine and corrects its position.
Surgical correction of scoliosis
Before deciding on the need for an operation, the orthopedic surgeon prescribes a thorough and detailed examination of the patient's internal organs and spine. If the operation is postponed for some reason, the patient is prescribed to wear an orthopedic corset, which slows down the development of the disease.
Absolute and relative indications for the operation:
- Disorders of the internal organs due to the approach of the deformation angle to 40-60 °;
- Severe pain, not relieved by non-steroidal drugs, responding only to the introduction of narcotic painkillers;
- Pronounced changes in the patient's appearance, which markedly change the quality of his life.
For the correction of the spine in the third degree of scoliosis, the installation of stabilizing systems on it is used to reduce compression. These are metal structures that rigidly connect deformed segments. Such systems are installed in adults and adolescents over 14 years of age, since the fixed segments of the spinal column cannot grow.
For the treatment of children who are operated on before the end of the period of active growth, the Harington and Cortel-Dubusset systems are used, which provide for the possibility of the development of the spine and the growth of its components. A successfully performed operation significantly improves the patient's quality of life, and allows restoring the functioning of internal organs.
Physiotherapy
The complex of therapeutic gymnastics for the correction of third degree scoliosis is selected individually for each patient, trying not to create unnecessary stress on the spine, which is already prone to trauma. Strength exercises, somersaults, sudden movements are prohibited.
The main exercises of remedial gymnastics:
- Walking in place;
- Rise on toes with outstretched arms;
- Abduction of the legs and arms while lying down;
- Raising the head together with the shoulders up;
- Raising the head, legs and arms up.
Learning the exercise therapy complex takes place under the guidance of an instructor, the exercises should be performed daily.
Massage
Therapeutic massage courses allow you to tone up certain muscle groups, relax excessively tense muscle clamps. The alternation of various techniques allows you to consolidate the achievements of physiotherapy exercises, relieve spasmodic pains. To increase the effect, massage movements are complemented by rubbing in analgesics, steroids. Warming ointments are used to speed up blood circulation.
Physiotherapy treatment and wearing orthopedic corsets
To improve blood circulation in areas of deformation, the effect of an electromagnetic field is used. Physiotherapy significantly alleviates the patient's condition if it is carried out regularly, in the form of courses, in the correct dosage.
Orthopedic corsets and bandages are designed to support the spine, to align it with compression, support while walking and sitting. Regular wearing of a corset helps to stop the progression of deformity and relieve pain. A special role is given to corsets during the rehabilitation period after surgery, when it is required to maintain the newly created position of the spinal column.
The transition of scoliosis to grade 3 is accompanied by the appearance of pain syndrome, deformation of internal organs, negative changes in appearance. Timely correction will help to partially restore the lost functions of the musculoskeletal, respiratory, cardiovascular systems.
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.
