Fundamentals of formation, causes, symptoms osteochondropathies kyphosis
Osteochondropathies kyphosis disease (Chairman Mau, juvenile dorsal kyphosis, youth apofiza) – the formation of abnormal concavity posteriorly in the thoracic spine. It occurs most often in adolescence (12-17 years).
Osteochondropathy vertebral bodies characterized by impaired conversion of the cartilaginous structures of the spine in bone, which leads to their wedge-shaped deformation. As a consequence, in juvenile kyphosis on radiographs formed the specific signs of pathology:
- Hernia Shmorlja (prolapse intervertebral disc in a cavity of a vertebral body);
- Wedge-shaped deformation of the vertebral bodies;
- Increased kyphotic angle concavity posteriorly.
Anatomically, the spine has 2 kyphosis in the thoracic and sacral departments. They represent a bulge of the spine posteriorly with an angle of 40 degrees. If the curvature exceeds 40 degrees, there is abnormal kyphosis.
Classification and the causes of disease
Pathology, depending on the causes is classified into:
Congenital kyphosis is caused by the presence of the wedge hemivertebrae, fusion of the bodies of some of them among themselves, anomalies of the structure.
Osteochondropathies Acquired kyphosis occurs when the presence in the body of osteochondropathy:
- Disease Chairman Mau;
- Tuberculous spondylitis (inflammation of vertebra)
- calve Disease;
- ankylosing spondylitis.
The Most often pathology develops in boys with the disease Chairman Mau. When radiographic examination it is characterized by a wedge-shaped deformation of the bodies 7 to 10 th thoracic vertebrae with the formation of hernias Shmorlja on several levels simultaneously.
In rickets in the body child has small amounts of vitamin D. It is needed to incorporate calcium in the bone tissue. Weak bone structure of the vertebrae is accompanied by a decrease in size.
Tuberculous lesions of the spine leads to various deformations. Against diseases does not exclude the formation of abnormal concavity posteriorly in the thoracic region.
The Disease is Lega-calve-Perthes is characterized by impaired conversion of cartilage to bone (osteochondropathy) in the small bones of the hands and vertebral bodies.
Neurofibromatosis accompanied by violation of the innervation of skeletal muscle. When the disease weakened the muscles of the back, so it cannot support the spine in the correct physiological position.
Ankylosing spondylitis is characterized by the deposition of calcium salts into the ligaments of the spine (ossification), leading to the restriction of his mobility. In such conditions not only increases the kyphosis, but becomes more pronounced lumbar lordosis.
Pathogenetic basis for the formation of osteochondropathy
Youth apofiza is observed on the background of degenerative changes in the intervertebral disks with ossification of the violation of their boundary plates. In the spongy substance of the vertebral body the space is, which over time penetrates a portion of an intervertebral disk (hernia Shmorlja).
In the course of osteochondropathy distinguish 3 stages:
Osteoporosis rarefaction of bone structure due to the low content or loss of calcium. Fragmentation is a separation of bone structure on a few ossification fragments, which are separated between each other by strips of cartilage. In the normal process of ossification (the deposition of calcium salts) area of bone (growth area) should be completely closed.
Repair – over time the cartilage strips are closed by calcium salts, but the process is individual. It largely depends on the quality of food, way of life and the nature of its power.
Osteochondropathies kyphosis is accompanied by lesions mainly the anterior Th7 segments-Th10 with a wedge-shaped deformation of the vertebrae.
In the initial stages the disease is asymptomatic. Parents of children with disorders go to the doctor usually in the presence of severe degree of the pathological thoracic kyphosis. In this condition in children, usually have the following symptoms:
- fatigue and weakness
- Pain in back when bending
- Increased heart rate when compression of the nerve roots in the thoracic spine.
These symptoms are not specific for the disease, so the diagnosis is based on radiographic examination of the thoracic spine. In the picture in the pathology are the following changes:
- Wedge-shaped thoracic vertebrae – front areas below the rear
- Articulargrounds are uneven and wavy contours
- Height of intervertebral gaps on several different levels.
Usually when osteochondropathies the kyphosis in the process involves multiple segments (5-8). The degree of curvature may be different, depending on the duration of the existence and severity of disease. For example, if osteochondropathy formed to 20 years, it is not accompanied by severe deformations of the vertebral column, but retains a lifetime.
A Period of juvenile dorsal kyphosis is characterized by 3 main stages:
- Initial – period immature vertebra when his body mostly consists of cartilage;
- Height – there is a fusion of several points of ossification;
- Residual effects – during the practical complete ossification of the bony structures of the spine.
The Clinic and symptoms of pathology will greatly depend on the stage that have any pathology and the magnitude of the concavity. Some influence on the severity of symptoms of the disease has a root cause osteochondropathy.
Juvenile kyphosis despite the illness of Chairman Mau is fixed, therefore does not disappear when bending or changing posture of the person. In rickets curvature is not noticeable when a person is in a horizontal position.
Tuberculous spondylitis leads to moderate or severe pain in the spine, but overall condition is satisfactory. When illness Lega-calve-Perthes usually "flattened" single vertebra, which causes compression of the nerve roots.
In conclusion: osteochondropathies kyphosis treated mainly physiotherapy and physiotherapy. Only in cases of severe curvature with pain syndrome is assigned to surgical correction of the axis of the vertebral column.