How to manifest and safe again whether congenital scoliosis of the spine?

Congenital scoliosis of the spine is a complex problem for physicians. Effectively and permanently cure it is nearly impossible, so we have to constantly advise and treat patients with this pathology. Given the nature of the symptoms of the disease, the international classification of diseases classified it as a separate nosological group: "Congenital scoliosis due to malformation of the bones."

the symptoms of congenital scoliosis may occur gradually over the life

cause of disease

Hereditary pathology is not necessarily manifested immediately after birth. The symptoms can occur gradually throughout a person's life.

What causes hereditary curvature of the spine in the frontal plane:

  • the Presence of hemivertebrae and wedge vertebrae;
  • Globalizacija and sacralization (fusion L5 S1 c and the transformation of L5 to S1, respectively)
  • Cleft vertebral arches in different parts of the spine;
  • Congenital weakness of the muscular system.

options breach of the merger of the vertebrae

wedge-shaped vertebral anterior body height less than the rear. This configuration leads to a shift of the curvature of the spine posteriorly. Though the symptoms of the pathology can grow in the next few years, if over and under pathological normal vertebra there are intervertebral discs, and the man has strong muscular frame back.

However, the law Hueler-Folkmann deformation will still grow over time, as the spine is constantly exposed to physical stress while walking, sitting or lifting heavy objects.

Hemivertebrae can merge with normal counterparts, causing a complex curvature (S or Z-shaped scoliosis).

Symptoms of pathology were studied Moscovice I. A.. According to his research congenital anomaly affecting the development of the spine, should be divided into:

  • Active (movable);
  • Inactive (fixed).

Spondylolysis – literally "the resorption of the vertebrae". Refers to the inactive form of pathology that is accompanied by a defect in interarticular part of the arc.

spondylolysis vertebra affects the development of congenital scoliosis

The Active form is characterized by rapid progression. If it is observed several anomalous vertebrae, which are arranged on one side of the body. From this configuration, it is difficult to get rid of conservative methods and surgical treatment will only help to align the spinal axis with metal structures, but they limit the mobility of the spine, therefore, only be undertaken if absolutely necessary.

If the abnormal vertebrae are disposed on opposite sides of the spinal column and separated by at least one normal vertebrae – an auspicious sign. In such a situation the vertical axis of the body may not be bent.

Classification of malformations of the vertebral column

11 variants congenital disorders of segmentation of the vertebrae

the figure contains 11 different variants of congenital disorders of segmentation of the vertebrae (type I in Winter)

depending on the severity of anomalies of the vertebral column in Winter they can be divided into 3 types:

  • type I is the anomaly of segmentation, which appear insignificant violation of formation of the structure of the spine;
  • type II – anomalies with the formation of double-sided blocks that restrict the mobility of the segments
  • type III – unilateral blocking of several vertebrae.

The segmentation Violation when I type in Winter may appear at any level of the spine, but are often detected in the thoracic region. The rate of progression of scoliosis in this situation depends on the number of segments involved in the pathological process.

Type II in Winter is characterized by the presence of pain with slight displacement of the spinal column in the lateral plane at the initial stages of the disease. Over time the deformity becomes more pronounced.

Type III soliten anomalies is the most dangerous because of rapid progression and the likely displacement of internal organs on the background curvature of the spine. Unfavorable course of the disease intensifies the presence of unilateral blocks in multiple segments simultaneously.

There are also combination options, when congenital scoliosis is formed on a background of multiple lesions of the spinal structures. In this form the patient has other stigma of dizembriogeneza:

  • Splitting of the upper lip and palate
  • Deformity of the ear;
  • Absence of the epiglottis;
  • Weakness of some pairs of cranial nerves
  • esophageal stricture
  • Tracheoesophageal fistula (between the trachea and pharynx).

Particular treatment

Conservative treatment pathology does not bringpositive results, therefore almost never used.

Surgical methods are used only after the child reaches 3 years of age. Universal method that can be applied to all patients does not exist. Most frequently in congenital scoliosis is applied posterior and anterior spinal fusion.

When the deviation of the vertebral axis posteriorly it is better to apply a posterior spinal fusion, as it does not require the use of special tools and is not characterized by large traumatic.

How is posterior spondylodesis:

  • the Surgeon "opens" the entire zone of deformation of the spine, including the upper and lower vertebrae in curvatures;
  • Rear segments open as wide as possible to have access to the top of the vertebrae;
  • Is resection (removal) of pathological adhesions of the intervertebral joints and rear structures;
  • To "seal" cracks apply the transplants.

Posterior spondylodesis may be supplemented by the installation of metal Harrington distractors, but this method can cause neurological complications. Used in patients with severe congenital scoliosis type III for Winter.

Front access is carried out in the presence of growth failure of the endplates of the vertebrae. In this case, the identification of anomalous structures is carried out at the primary stage of the procedure that determines the further tactics of manipulation.

The Difference between this type of intervention from the previous version – the spine is not only locked, but also prevents the growth of the bone structure by the warp.

In the presence of hemivertebrae may be extraction. The operation involves the complete removal of abnormal structures in 2 stages. In order to maintain the vertical axis of the trunk set metal distractor in the spinal column.

In some European clinics operation is performed in one stage using the techniques of Sono. This type of intervention is only possible with an isolated hemivertebrae.

Thus, congenital scoliosis it is necessary to identify the child in the early stages in order to eliminate the deformation. Otherwise, she over time will only progress.