The causes of development, symptoms and treatment of scoliosis of the spine 2 degrees

2 degree Scoliosis is a lateral displacement of the axis of the vertebral column with an angle of curvature from 11 to 25 degrees. Causes of disease are numerous, but 80% of it is due to a combination of multiple precipitating factors.

Main causes lateral displacement of the spine

In children, idiopathic scoliosis is most often characterized by a deviation of the vertebral axis to the left in the thoracic and lumbar. Explanation this factor – the deviation of the axis of the spine to the side opposite the writing hand.

To further consider the causes of the disease, we propose to study the biomechanical models of scoliosis of 2 degrees:

• Organ model considers the spine within functional unit together with the internal organs. This consistent, stable, semi-rigid design is resistant to the action of gravity from top to bottom.

nevertheless, under the influence of external loads along the vertebral axis always formed a Central bulge – knee. Its curvature is equal to the ratio between power influence and force of muscle contraction (f1 and f2). For a structure to remain stable, on the top of it bulges outside need to act in a contrary force (f3), which stabilizes the curvature. This force comes from the muscles of the back.

• Segmental model explains the causes of scoliosis from the standpoint of individual functionally interconnected blocks (vertebral motor segment). This education consists of individual bone structures in the vertebrae (spines, cartilage), which are interconnected by an articular-ligamentous apparatus.

According to the segmental model of the causes of spinal curvature is several factors that act on different levels (see figure).

Lateral curvature of the spine according to the segmental model is triggered by the following factors:

1. Shortening of the anterior column of the spine due to deformation of the vertebral bodies (1)
2. Segmental instability in the anterior column of the spine (2);
3. Fibrosis in the anterior longitudinal ligament with subsequent blocking (3)
4. Pathological kyphosis in the thoracic region of the spinal column (4);
5. Instability of the posterior column (5);
6. Voltage short and long muscles of the back (6)
7. Increased lordosis in the lower back (7)
8. Reloading the deformation of the vertebral bodies (8).

Symptoms of scoliosis of the second degree

The Symptoms of lateral deformation of the spinal column can be divided into:

• Vertebral syndromes occur due to pathology of the vertebrae, intervertebral discs and other components of the muscular-skeletal segment of the spine. Most often when a scoliosis 2, grade 3 and 4 appears a compression syndrome due to compression of a nerve.
• Extravertebral symptoms are formed due to displacement and disturbance of innervation of the internal organs. Among them is often found cardiac, renal and intestinal pathology.

To cure a disease, the doctor is important to determine the extent of its progression and possible complications in the future. To determine the progression of the curvature is possible by the analysis of direct radiographs of the patient for signs of Mehta.

The First sign is determined on the radiograph, when the difference between angles a and b (see figure) does not exceed 20 degrees. The probability of progression in this situation is also equal to 15-20 degrees.

The Second parameter characterizes the amount of torsion (twisting of the vertebra along the vertical axis). An unfavorable torsion 2, grade 3 and 4 (see figure phase b).

Thus, scoliosis of 2 degrees to cure with conservative methods, but to approach this process correctly. Proper treatment of pathology must be based on the principles of modeling of a condition of the spinal column of the patient and assess the likelihood of further progression of the curvature.

Treatment on the basis of modeling

based On the above models is the most effective treatment of frontal displacement of the spinal column. Its basic principles are:

• Forces, which are directed along the spine, and orthotics require conservative treatment and can eliminate the deformation;
• Manipulation to correct vertebral axis should counteract the factors that cause the instability;
• Orthotics and other conservative methodstreatment is directed against the forces that cause deformation.

Based on the above principles, we can put forward the assumption that to correct the spinal deformity following technical elements:

• using the distraction of structures on the affected side
• Applying compression with orthopedic products;
• with the multi-axis spinal Fixation constructs with multiple segments, which affects several pathological convexity (in S-shaped scoliosis);
• Differentiation between the choice of corrective efforts and the amount of deformation.

To effectively treat lateral curvature, is insufficient using these methods. Obviously, it is necessary to apply the principles of assessing the quality of treatment. For these purposes in most countries also use a measure of the quality of life Barthel (Barthel). Its application allows to calculate the total level of domestic activity in points. Depending on the significance of each parameter of the test is estimated at 5-15 points. In healthy man this index is equal to 100 points. If it is smaller, it is obvious that it is necessary to correct the dislocation of the spine.

A sample list of issues of scale, Barthel:

1. meal:
   • Fully dependent on others – 0 points;
   • Regardless of the people – 5 points;

2. Private toilet:
   • Need help – 0;
   • doesn't need help – 5

3. bathing:
   • Need help – 0;
   • doesn't need help – 5.

On the basis of these criteria, you can determine the quality of treatment of the patient with lateral curvature of the spine. The Barthel scale also allows you to determine how effectively treated the various symptoms of the disease.