Types, symptoms and treatment of scoliosis of the lumbar spine

Scoliosis of the lumbar spine is formed due to the different pressure on the intervertebral discs muscle imbalances, prolonged sitting, injuries to the vertebrae. As a result of these factors and the displacement of vertebral segments in different sides of asymmetry occurs, which further leads to the displacement of the vertical axis of the spine to the right or to the left with a vertical rotation of the vertebrae (rotation and torsion).

The displacement of the intervertebral disc is formed by irritation of the surrounding soft tissues. Inflammation of the muscular-ligamentous apparatus leads to stimulation of nerve receptors located in the ligaments. Pain is enhanced by the displacement of internal organs: liver, intestines, the pelvic organs.

Types and degree of lumbar scoliosis

The Lumbar scoliosis is classified into the following types:

• 1 degree of angle of curvature of from 5 to 10 degrees;
• 2 degree of bending curvature from 11 to 25 degrees;
• 3 degree of curvature reaches 50 degrees;
• 4 degree curvature angle exceeds 50 degrees.

The Data extent is set on the basis of radiographs in the direct projection of the lumbar spine. The pictures are drawn lines parallel to the vertebral end plates of the vertebrae, forming the top and bottom curvature.

Perpendicular to it are lines that intersect each other. At this point measure the angle of curvature (Cobb method).

depending on age characteristics of lumbar scoliosis can be divided into 3 age groups:

• up To 8 years. In this time period the vertebrae are cartilaginous structure. Only 8 years, there is ossification of their bodies;
• With 8 to 14 years can be traced foci of ossification in the area of processes and the arches
• From 15 to 17 years ends with the formation of the spinal column and the vertebrae together with the intervertebral discs form a single bone structure, which persists throughout life.

While in the vertebrae remain cartilaginous part the doctors are able to correct the pathological curves. With age, the treatment of lateral deformations is difficult and involves only the strengthening of muscle ligament-apparatus to prevent further displacement (bending of 2 degrees) or surgical reconstruction of the vertical axis of the body structures (when warp 3 and 4 degrees).

Left-sided scoliosis of the lumbar spine with apex at L3 (the vertebra with a wedge-shaped deformation). The patient is severe pain radiating to the gluteal region and lower limbs.

Diagnosis based on external examination

There are diagnostic symptoms of the disease, allowing to identify the disease on the basis of visual inspection of a person:

1. Misalignment of the pelvis, shoulders drooping, their different location, the asymmetric localization of the head, a wrong structure of the triangles waist – lumbar scoliosis of 1 degree;
2. Asymmetry of body contours, the displacement of the blades, the spine hump – symptoms of curvature of 2 degrees;
3. Severe deformation of the chest, the divergence of the blades and the clear muscle of the thoracic cushion – symptoms of spinal deformity 3 or 4 degrees.

Muscle roller becomes clearer when bending person. If pathology is not accompanied by impairment of nerve fibers at a given degree of deformation is not generated pain syndrome. External cosmetic defect in this situation always causes a person to seek professional help. Only with protrusion of intervertebral discs appears lumbago (backache), forcing to visit a doctor, but at this stage of the disease completely cured it is virtually impossible.

Neurological signs

depending on the disturbances of motor activity in frontal deformation providing 4 types of violations:

• Hypermobility option with intervertebral osteoarthritis on the background of functional disorders;
• Organic hypermobility syndrome;
• Hypomobility syndrome with functional disorders in the intervertebral joints;
• Organic hypomobility option.

Hypermobility variant with changes in the intervertebral joints characterized by pain along the spinal column alone. Pain is starting and arise in the morning after sleep. Their features:

• Appear in the beginning of the movement;
• Amplified under static load;
• is Reduced during prolonged walking;
• Combined with stiffness of the joints (the swelling)
• Crunching in the spine while turning and tilting the torso.

Lumbar scoliosis of 2 degrees withhypermobile syndrome Of the intervertebral joints characterized by gradual progression. It always is observed vertebral syndrome (local pain along the vertebral column). Limitation of range of motion of the spine appears only in the affected area.

Organic hypermobility syndrome, with 2 degree lateral curvature combined with myopically (spastic muscle contractions in the affected area). Thus, the local increase of tonus of skeletal muscles primarily observed in the localization of intervertebral arthrosis. Palpation of the hard muscle tenderness. When feeling in periartikuliarnah tissues (around joints) can be seen swelling. This form of the disease occurs on the background of organic disease of the vertebrae: arches damage, bodies or unstable vertebral segments.

Hypomobility functional variant Observed in patients with degenerative changes of the vertebrae (decrease in the amount of calcium in the composition, the pathological reaction with deposition of calcium salts).

In dystrophic changes in the intervertebral discs increases the pressure. They protrude and put pressure on surrounding soft tissues. Due to irritation of receptors of the ligaments appear muscular-tonic responses (spasserovannye skeletal musculature). In response to such changes are observed the emergence of degenerative disc disease (a reduced height of intervertebral disks) and scoliosis.

Organic hypomobility syndrome Occurs on the background of diseases associated with limited mobility of the functional blocks of the vertebral column. The evaluation of patients with this pathology is not only a lateral curvature of the lumbar spine and strengthening of the lordosis of the lumbar kyphoscoliosis formation. Due to compression of the spinal nerves in organic hypomobile version appears compression syndrome.

How to treat the disease

Treatment of lumbar scoliosis requires a comprehensive approach with the inclusion in the scheme of therapy:

• physiotherapy
• Massage
• Coretelephony;
• Traction.

The selection of therapeutic exercises in this condition should be approached with extreme caution. Curvature of 2 degrees is accompanied by infringement of spinal nerves, so any movement will lead to greater syndrome. In professional rehabilitation centers instructors choose exercises for each individual patient.

Approaches to stretching from different doctors opposite. It helps to increase the height of intervertebral disks, but can lead to hyperextension of ligaments and muscles with the formation of cracks and tears.

Corethrogyne assigned when the curvature of the vertebral axis of 2 degrees. It helps to prevent progression of the deformity and relieve the tension from the muscles. It should not be used for a long time that the muscles have not lost functionality.

surgical treatment deformation includes 2 types of interventions:

• Simultaneously;
• Landmark

One-stage surgical treatment involves the installation of metal structures in one go. These devices will maintain the vertical axis of the body in the correct position.

The Staged operation involves the installation of pins for several times. The primary stage involves the elimination of organic disorders in the area of damage. Metal pins embedded in the spine at the next stage.

Thus, the symptoms of lumbar scoliosis of 2 degrees are threatening pathology. Their treatment is better to start from the early stages, as follow-up to fully restore the vertical axis of the torso will be quite difficult. If the angle of curvature reaches 50 degrees will need surgery.