Symptoms, diagnosis, treatment of enhanced youthful kyphosis

Juvenile kyphosis disease (Chairman Mau, juvenile dorsal kyphosis, kyphosis osteochondropathies, youth apofiza, kyphosis apprentices journeyman) – flexion accompanied by excessive convexity posteriorly in the thoracic spine with angle greater than 30 degrees.

Doctors disease encrypt code M42.0 (international classification of diseases (ICD).

The Pathology occurs primarily in boys between 13-17 years of age and is characterized by the presence of wedge-shaped deformation of the vertebrae at the same time in different divisions of the vertebral column. This increases thoracic convexity with apex at the area 7 and 10th vertebrae (Th7 segments-Th10).

Such changes are accompanied by infringement of spinal nerves in region of vertebral holes, which leads to the appearance of pain in the chest, faulty heart and the respiratory system, loss of cutaneous sensation in the upper extremities (in severe compression).

The Study of the disease he studied German and Danish orthopaedic Mau K. And Scheuermann, who found that when the disease occurs in the vertebrae of dead tissue (aseptic necrosis). Consequently, the first sign of the disease can be hernia Shmorlja (vtyanutoj intervertebral discs in the vertebral body).

What is uvenilny kyphosis

Anatomically, the spine has 4 curves. Curves bulge back are located in the thoracic and sacral departments. Bulging forward (lordosis) localized in the cervical and lumbar. Such a "design" to prevent the infringement of spinal nerves during exercise, flexion and extension, walking.

If increasing the curve in the thoracic region greater than 30 degrees, there is abnormal kyphosis (Hyper-kyphosis). With youthful opopsite he often shifted more to the right or to the left with the formation of kyphoscoliosis.

For the diagnosis of diseases, Chairman Mau must have 2 person-specific attributes:

• Wedge-shaped deformation of the vertebrae;
• the Emergence of a few vertebrae hernias Shmorlja.

These changes can be detected by radiological methods (computer tomography, radiography of the spine) and magnetic resonance imaging.

The Specific age features of the disease (occurs in 13 to 17 years) due to the period of active growth of the skeletal system, which not "have time" to skeletal muscles. Against this background the muscles of the upper third of the back "pulls" the spine in their side, is therefore increased thoracic curve.

It Should be noted that 20-25 years ending transformation of the structure of the vertebrae from cartilage to bone. If the deformity is not corrected, the stoop and the spine and the hump remains for life. To correct a pronounced deformation can only be made operational methods, involving the insertion of metal clips.

causes of enhance breast concavity boys

Strengthening the thoracic concavity of the spine in young people occurs for the following reasons:

1. School and office way of life.

The Formation of correct posture in pupils is impeded by objective reasons. They are a large amount of time behind a school Desk, sitting at the computer, watching TV on the couch. This behavior is contrary to nature, which suggests that bipedalism person for hunting, gathering berries and mushrooms, farming. On vacation in the struggle for survival is allocated a small amount of time.

2. weakening of the muscular corset back.

In the 21st century people most of the time in a sitting position. As a result, the muscular system loses its static and dynamic properties. As a result of weakness of the vertebral column is not supported in the physiological position.

The Weakening of the muscular system doctors believe the main cause of juvenile kyphosis. If the child is properly holding the posture, the muscles quickly become tired, and stoop to get progressively worse.

When expressed curvatures of the weakening of skeletal muscle even affects the bones. Vertebrae, left without the muscular system, during prolonged walking, jumping, lifting weights is subjected to compressive pressure and quickly deformed. Over time they flattens one side (wedge-shaped deformity).

3. Strain the chest muscles.

The Tension of the chest muscles creates an imbalance. Some adolescents desire to appear attractive are starting to "pump up" the muscles by using dumbbells and weight machines. They make a serious mistake – increase the strength of one group of muscles or the chest leads to the stoop,as there is an asynchrony in the functioning of the muscular system of the back.

Pump up your chest is necessary in the ratio of 2:1. That is, exercises to strengthen back muscles need to devote to 2 times longer than skeletal muscles of a breast. If the proportions are violated, the chest becomes sunken, and the back will be round-shouldered.

4. High rise
5. "Psychological slouch".

Psychological causes of juvenile kyphosis are that the young man wants to "shrink", "hide" or become less visible. This complex is often observed in adolescents who are growth above their peers.

There are more rare causes of disease:

• Congenital excessive concavity in the thoracic region. Such pathology is often associated with paralysis of the legs. Treatment of the disease is rapid;
• Rachitic kyphosis appears due to inadequate dietary intake of vitamin D. Without treatment, the curvature is progressing rapidly;
• Paralytic deformity of the thoracic spine caused by diseases of the neuromuscular system (cerebral palsy, poliomyelitis, syringomyelia);
• post-Traumatic curvature is a consequence of vertebral fracture.

Clinical pathology

The Clinical picture of juvenile dorsal kyphosis disease (Shearman Mau) depending on the severity of the curvature and the stage of the disease.

The Clinic of the disease has very specific symptoms:

• Patients complain about fatigue and pain after prolonged sitting;
• Pain is rapidly relieved by analgesics or disappear after the transition in horizontal position;
• In the external examination of the back there is a "round" kyphosis, characterized by uniformity of the arc of curvature throughout with a large radius;
• half of the patients Have spinal curvature in a lateral plane;

When you are feeling the spinous processes of all thoracic vertebrae, you can feel pain. This is a symptom of differential diagnosis, as in destructive deformation of the vertebral bodies is observed only local tenderness at the injury site.

Diagnostic criteria

In the early stages there is a slight decrease in the height of the thoracic vertebrae, so children's complaints, there was very little. The leading symptom at this stage would be an increased curvature of the vertebral column. Timely detection of this pathological condition is difficult because there is a physiological kyphosis in the thoracic region, so that parents difficult to establish the border between norm and pathology. To determine this boundary on the basis of the following diagnostic feature:

• maximum flexion of the physiological kyphosis disappears completely;
• abnormal protrusion remains in this position.

Radiological signs of early stages of disease Chairman Mau clearly did not manifest themselves. With the help of x-rays can be detected only indirectly symptoms, emerging pathology:

• Uneven shade of the apophyses of the vertebrae;
• Single hernia Shmorlja;
• Minor osteoporosis (rarefaction of bone structure) vertebral;
• Small, wedge-shaped deformity of the individual vertebrae.

To assess the severity of concavity used a technique of Cobb. It allows to measure the vertex angle of curvature on a lateral radiograph of the vertebral column. When the radiologist conducts a line parallel to the vertebral end plates of the vertebrae at the beginning of the arc curvature. These lines are perpendiculars. At the point of intersection measures the angle of kyphosis.

If it does not exceed 40 degrees, the concavity is posterior to physiological. However, this value is relative because there are individual characteristics of the organism. For some people, a curvature of 30 degrees is already pathological. Due to the indirection of the above signs x-ray study does not play a decisive role in the diagnosis of disease.

The conclusion of the radiologist about osteoporosis is also relative. On the resolution of the bone structure of the vertebrae can only be judged after the results of photodensitometry. It involves placing the soft tissue of etalons of optical density of bone tissue, with which is compared the intensity of the bone structure.

Diagnosis of juvenile kyphosis Cobb method

Difficult x-ray diagnostics of pathology of the fact that in the sagittal plane of the body of the thoracic vertebrae, located in the top of the physiological kyphosis may have a wedge shape in children aged 12-14 years. Youthful kyphosis the initial stages is characterized by a slight wedge vertebrae 5-7 percent, which is difficult to distinguish from the norm.

Thus, none of the above factors leads to reliable signs for the diagnosis of the disease. As a result, juvenile kyphosis can be set only when the angle of curvature exceeds 40 degrees and there is a wedge-shapeddeformation of the vertebrae with hernia Shmorlja.

On the basis of x-ray images of the thoracic you can set the severity of the pathology:

• moderate damage to vertebrae the height of their anterior increases in extension, and posterior portions of the intervertebral gap is reduced (less than 3 mm);
• Severe fibrosis is not accompanied by an increase in the anterior height of the intervertebral space in extension, and the height of the rear is significantly reduced;
• In total fibrotic changes in the spine decreases the height of all the departments of the intervertebral disc.

Principles and methods of treatment

Youth apisit is a serious disease that over time causes changes in almost all the internal organs.

In the initial stages of the disease is assigned to daily physiotherapy exercises to strengthen the back muscles. It is also advisable swimming, sleep on a hard bed, and restorative procedures. This treatment is used if the magnitude of concavity is equal to 45-50 degrees.

With more severe kyphosis, you need to eliminate all kinds of congestion (sports, weight lifting, jumping, hard work). After school, children should remove the fatigue of back muscles. To do this, doctors recommend rest in the horizontal position for 1-2 hours. To strengthen back muscles are recommended special exercises, but they should be individualized by your doctor.

Comprehensive treatment of a pathology requires the wearing of a corset Milvoki and Risser and reclination. Fixed kyphosis in adolescence requires surgery.

In conclusion it should be added that juvenile kyphosis is easier to prevent than to treat. If the disorder has no cure up to 20 years, and after that return to the physiological axis of the spine cannot be used.