Healthy spine of children
The formation of the spine occurs in childhood and continues into adolescence. Scoliosis usually occurs in children and adolescents during periods of strongest growth, as it can increase spinal deformity.
Among five-year-olds, about 10 percent of children suffer from scoliosis. By the end of school scoliosis is detected in almost half of adolescents. Girls more often than boys are at risk, as they lead a less mobile lifestyle.
The most dangerous age for the development of scoliosis is the period from 10 to 14 years, when the skeleton has not yet fully formed, and the child more often than before, sit at the table, preparing lessons, or spending time at the computer (again sitting), playing and etc. Diligent "home" children overloaded with training sessions often have spinal diseases. The development of scoliosis contributes to incorrect posture, leading to uneven load on the spine and muscles. In the future, there is a change in the ligaments of the spine, the deformation of the vertebrae themselves - as a result, a stable lateral curvature is formed.
Early diagnosis of the disease - the key to success in the treatment of scoliosis, and therefore parents should make every effort to ensure that they do not miss the onset of the disease.
It is very easy to determine the presence of scoliosis (not the degree of scoliosis, which only the doctor must determine!) - just look at the child’s back carefully enough. Ask him to stand up and take a comfortable position for him - his arms are lowered, his muscles are relaxed, and we do not specifically pull out his back. Notice at what level the child has shoulders - which shoulder is higher, which is lower, at what level is the bottom of the scapula - higher or lower? Look at the sides: one side can be drawn in more than the other, and if the child is plump, then there can be a fold on one side (and not on the other), perhaps one of the sides will be convex.
The presence of at least one of the above signs in both a child and an adult is a serious cause for concern and a visit to a specialist who can confirm or deny your suspicions, and also order additional examinations.
Instrumental survey methods
After an examination, if the doctor confirms your suspicions, you will most likely need to conduct a series of instrumental examinations. First of all, X-ray is one of the most widely used methods for diagnosing spinal curvature.
X-ray examination of any part of the spine is called "spondylography." X-rays of the spine are performed in the standing and lying positions, and a profile picture is taken in the lying position.
Only after careful examination of spine radiographs in standard projections to clarify the information obtained can be assigned additional research in other projections - when the spine is bent and extended and even when it is stretched, as well as in a sitting position with an inclination to the right and left.
Radiographically, any spinal curvature greater than 10 ° can be determined. However, soft tissue (ligaments, muscles, disks, etc.) are not visualized on radiographs. To clarify the diagnosis, detection of compression of nerve structures, other diagnostic methods are used. For example, in the presence of neurological symptoms, magnetic resonance imaging (MRI) may be required.
Magnetic resonance imaging (MRI) is a method based on obtaining images of tissues and organs using electromagnetic waves. This diagnostic method is safe and can, if necessary, be used repeatedly in one patient. The resulting tomography digital data. Subjected to computer processing. The MRI image is presented as a series of longitudinal and transverse sections. MRI is the "gold standard" for the diagnosis of pathological changes in soft tissues, such as nerve structures, ligaments, and muscles. MRI can reveal degenerative changes in the intervertebral discs, hypertrophy of the facet joints, spinal canal stenosis, disc herniation and other pathological conditions.
Computed tomography (CT) is a method in which x-ray radiation is used to image tissues and organs in the same way as with conventional radiography. The information obtained is subjected to computer processing, with the result that the image is presented in the in-ide series of longitudinal and transverse sections. With CT, it is possible to study both bone structures and soft tissues. However, computed tomography is the most informative for detecting pathological changes in the bone tissue, for example, osteophytes and hypertrophy of the facet joints. The image of soft tissues on computerized tomograms compared with MRI is not so clear and informative. In order to increase the informativeness of research in the diagnosis of soft tissue pathology, computed tomography is often combined with the performance of myelogram.
Myelography - this method is leading to the study of soft tissue structures of the spinal canal, including the spinal cord and nerve roots. Before performing the myelogram, a contrast agent is injected into the spinal canal (beneath the membranes of the spinal cord). This is done with the help of a special needle, which is inserted below the end of the spinal cord (in the lumbar region), so damage to the nerve structures during this study is practically excluded. Contrast material spreads through the spinal canal, flowing around the spinal cord, nerve roots. Next, a spinal X-ray is performed. Myelography allows you to identify a herniated disc, a tumor or a fracture of the spine.
Radioisotope scanning is based on the registration of the radioactive radiation of the patient’s body after administration of the radioactive drug orally or intravenously using a special gamma camera. The isotope accumulates in certain tissues and organs. The duration of the half-life of medical isotopes is only a few hours, and the intensity of their radiation is extremely low. Therefore, this diagnostic method does not represent a danger to the patient's health. Normally, a radioactive drug is distributed evenly in the bone tissue. In case of focal pathological processes, there is an uneven distribution of the radioactive drug: excess (“hot” hearth) or insufficient (“cold” hearth) accumulation in pathological areas. The image of the organs and tissues in which isotope accumulation occurs is obtained using a special gamma camera. Radioisotope scanning is most informative for the diagnosis of neoplastic diseases of the spine, as well as metabolic bone diseases, for example, osteoporosis.
Ultrasound examination (ultrasound) is not the main method for diagnosing diseases of the spine, since the high density of the bone tissue of which the vertebral body consists does not allow a sufficiently clear and contrasting image of the structures of the spine to be obtained with an ultrasound scanner.
All the methods listed here make it possible to achieve one specific goal - to make an accurate clinical diagnosis. It is necessary to understand how to deal with the disease. In most cases, patients with spinal curvature are treated conservatively (surgical methods are shown only to those who suffer from severe forms of the disease). The main component of conservative therapy is physiotherapy. The remaining methods (for example, massage or the use of special corsets) are considered auxiliary.