Kyphosis of the thoracic spine: photo, symptoms, treatment

The spinal column of a person without pathologies of development, when viewed in the sagittal plane, presents a series of curves of physiological properties.

A bend in the inner side is characterized by lordosis in the cervical and lumbar spine, a bend in the outer side is characterized by kyphosis of the thoracic or sacral parts.

Such bends preserve the mobility and flexibility of the spine, contribute to the maintenance of various loads.

Normal physiological kyphosis should not exceed a 45-degree deviation. Curvature exceeding the norm refers to vertebral pathologies.

The causes of kyphosis

The development of the disease manifests itself for many reasons:

• pathology of the intrauterine nature;
  
• consequence of injuries and surgical interventions;
  
• due to pathological compression fractures of the vertebrae;
  
• consequence of the formation of incorrect posture or psychological stress;
  
• heredity;
  
• as a result of muscle paralysis( cerebral palsy, poliomyelitis);
  
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• consequences of disc herniation and compression of nerve roots;
  
• neoplasm on vertebral discs;
  
• infectious diseases.

Based on etiological signs, the disease is classified into several types.

Classification by species

The manifestation of functional kyphosis is due to the muscular weakness of the back. It looks like the usual stoop, acquired in the wrong position while working at a table or the consequence of a psychological factor, when they are shy of their growth, involuntarily slouch, trying to be lower.

Often the psychological factor is expressed in girls during puberty, when they slouch, involuntarily trying to hide the growth of the breast. When the back is placed horizontally on a solid surface, kyphosis does not appear. Also disappears with an independent desire to straighten.

No radiative vertebral anomalies are detected with x-rays.

The young dorsal kyphosis or Sheyerman-Mau disease is characterized by a high degree of bending deflection( up to 75 grades).Such deformation manifests itself as a result of hernia formations in the thoracic intervertebral discs, which is the reason for the formation of several wedge-shaped vertebrae.

Versions of pathology formation set:

• hypertrophy of anterior ligament of intervertebral discs;
  
• avascular necrosis of hyaline cartilage, disrupting bone growth;
  
• or excessive growth of bone tissue on intervertebral sites;
  
• pathological processes in muscle tissue;
  
• is a consequence of osteoporosis and many other versions.

But all researchers agree in the same opinion - the disease is hereditary.
Congenital disease is caused by intrauterine pathologies. Concomitant disease can be congenital paralysis of the legs and abnormalities of the urinary tract.

1. 1) Paralytic appearance is a consequence of cerebral palsy or poliomyelitis. Complicated by deformation of the spinal column.
   
2. 2) Post-traumatic appearance is the result of injuries and fractures in the thoracic or lumbar spine.
   
3. 3) Post-operative appearance of kyphosis - associated with unsuccessful stabilizing operations on the spine.

The degenerative form of the disease develops due to certain reasons:

• excessive loads;
  
• due to spondylitis;
  
• of neoplastic tumors;
  
• is a consequence of radiation therapy.

Symptoms of kyphosis and stage

Few people pay attention to the seriousness of such a disease. Well, what can be dangerous in the usual stoop? Kyphosis, and its symptoms from the degree of curvature of the spine expressed:

1. 1) Hypokyphosis with a curvature angle of up to 15 degrees.
   
2. 2) Normal kyphosis with a bending angle reaching 50 degrees.
   
3. 3) Hyperkifosis, when the bend exceeds 50 degrees.

The human spine is a kind of trunk, providing a safe delivery to all human organs of nerve fibers.

Kyphosis, leading to the infringement of neural bundles and fibers, is often expressed by violations of the motor functions of the lower limbs, until complete immobility.


Symptoms of thoracic curvature are manifested depending on the degree of development of kyphosis. This is expressed by:

• with painful spasms in the bend area;
  
• numbness and weakness in the legs;
  
• heart rhythm disturbance;
  
• problems with breathing and digestion( in complicated cases);
  
• is a violation of sexual functions.

Progression of the disease, without proper treatment passes into the stage of hunchback. The formation of the hump provokes:

• a decrease in free chest space;
  
• formation of diaphragmatic hernias;
  
• limited mobility of the chest;
  
• difficulty breathing.

Violation of respiratory activity causes stagnation in the lungs, leading to chronic respiratory failure, pronounced blueing of the nasolabial area and endings of finger phalanges. As a rule, patients with a hump for a long time do not live. Changing the position of the heart, with kyphosis, is inevitable, and invariably leads to heart failure, and the lungs are constantly exposed to inflammatory processes.

See also, lordosis of the lumbar spine.

Diagnosis of kyphosis

To compile an effective treatment plan, various diagnostic methods are used to establish the correct diagnosis - physical and instrumental.

The first step in the diagnosis of the thoracic kyphosis is the medical history:

• the definition of a genetic predisposition - an anamnesis of the disease in the family.
  
• the time of manifestation of the primary signs of kyphosis bending;
  
• determine the level of progression of the disease from previous pictures( if any).
  
• determine the nature of the pain, if they are present.
  
• detection of the presence of intestinal dysfunction or disorders in the urinary system
  
• assessment of motor functions.
  
• revealing the presence of surgical interventions on the backbone in the anamnesis.

The next step is a physical exam. Determination of the effect of curvature on the health of the patient:

• definition of the motor functions of the back;
  
• degree of bending;
  
• determination of the patient's flexibility in different directions;
  
• reveals the lesions of certain nerve endings when evaluating reflexes and muscle strength.
  
• uses special tests to identify irritated or clamped nerves.

Instrumental methods:

1. 1) X-ray examination in various positions( standing or lying), front, side and lateral bending, helps to determine structural changes in the spine and measure the angle of curvature.
   
2. 2) The MRI method allows you to view changes in nerve fibers and changes in the spinal cord.
   
3. 3) The CT method allows obtaining more complete information on structural bone changes.

How to treat the kyphosis of the thoracic spine?

The treatment plan is always tailored to individual needs. Consists of their conservative treatment and extreme method - surgical.

Conservative treatment of kyphosis , which includes drug therapy, is aimed at reducing pain symptoms. It should be clearly recognized that no drug therapy is able to completely cure the curvature, its task is to facilitate the course of the disease.

When kyphosis of the thoracic spine, complicated by osteoporosis, treatment of the background disease is carried out, preventing various vertebral fractures. Assignment:

• hormone therapy;
  
• vitamin complex;
  
• exercise complex with loads.

For relief of pain, a special dorsal fastening is used - staples. If a leg is shortened and the patient experiences pain during such a walking curve, special orthopedic shoes or orthopedic insoles are prescribed.

Physiotherapeutic treatment of kyphosis is one of the important components in the treatment of kyphosis bends. Compiled by:

1. 1) In view of training programs aimed at the correct mechanics of maintaining the vertical position of the body;
   
2. 2) Recommendations for maintaining the maximum active level;
   
3. 3) An individually formulated exercise plan, taking into account stretching exercises and compulsory swimming procedures.

The use of supporting corsets and staples is an invariable attribute of treatment of curvature in the case of Sheyerman-Mau disease.

Surgical treatment of kyphosis

Surgical intervention in thoracic kyphosis is applicable in the following cases:

1. 1) When conservative methods do not bring the desired results and pain symptoms are not manageable
   
2. 2) In cases of progressive kyphosis, to prevent the effects of severe forms of kyphosis.
   
3. 3) In some cases, with large physical deformities caused by curvature.

Surgery for kyphosis has various methods directed:

• to reduce the deformation of the spine;
  
• preventing the progression of the disease;
  
• retention of afferent connections, eliminating pressure on nerve endings;
  
• protection against further damage.

The operation of spinal fusion is the straightening of individual parts of the spine by fixing the curved portion into an inner bracket made of metal plates and screws.

Minimally invasive procedure - kyphoplasty. It is used to alleviate pain symptoms in the back and restore spinal injuries. A small incision injects a special solution( bone cement) into the damaged vertebra.

The osteotomy method is used to correct curvature and angular deformation by reducing the vertebral wedge.

Prevention of kyphosis

Prevention aimed at preventing the disease contains several rules:

• fitness for the young and exercise therapy for the elderly.
  
• with sedentary work recommended gymnastic exercises to maintain normal muscle tone.
  
• visit a child psychologist or explanatory work with psychological problems that cause stoop.
  
• match the size of the desk and chairs according to the height of the person.

With an early kyphosis, a specialized corset can fix the situation. The order of wearing will be determined by the attending physician according to the degree of development and symptoms of the disease.

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