Spinal deformities and back pain
Last reviewed: 23.04.2024
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Deformation of the spine is called the deviation of the spine as a whole, its sections or individual segments from the middle physiological position in any of the three planes - frontal, sagittal, horizontal. Deformations of the spine are the most typical clinical manifestation of vertebral syndrome and in their essence can be primary, i.e. Is an independent pathology, or secondary, i.e. To accompany diseases of other organs and systems.
There are the following types of deformities of the spine:
- Scoliosis - deformation in the frontal plane
- Kyphosis-deformation in the sagittal plane, apex of the arc directed dorsally
- The lordosis-deformation in the sagittal plane, the apex of the arc directed ventrally
- Rotation - non-structural deformation in the horizontal plane
- Torsion - structural deformation in the horizontal plane Often, deformations are mixed (polycomponent).
By localization, the deformation vertices are divided into craniovertebral (the vertex is located at the level C1-C2); cervical (C3-C6); cervicothoracic (C6-T1); thoracic (T1-T12), including upper- (T1-T4), medium (T5-T8) and lower thoracic (T9-T12); chest-lumbar (T12-L1), lumbar (L2-L4) and lumbosacral (L5-S1).
On the side of the location of the apex, right-sided and left-sided deformations are distinguished.
Taking into account the peculiarities of the curvature of the spine, characteristic for each specific disease, typical and atypical deformations are distinguished.
Taking into account the presence of physiological curvatures of the spine in the sagittal plane, when describing gently kyphotic deformations in the thoracic region, not only their absolute value, but also the ratio with the parameters of the physiological thoracic kyphosis, are taken into account. Sloping kyphosis is usually formed by 8-10 vertebral segments.
In the quantitative assessment of pathological kyphosis (buttoned, trapezius and angular), the absolute magnitude of the deformation is determined between the cranial and caudal neutral vertebrae closest to the vertex. Kifotic arc, as a rule, is formed by 3-5 vertebral segments. In the evaluation of lumbar inversion (see terms), the actual strain is determined by the sum of the measured value of kyphosis and physiological lordosis.
In the presence of changes in the microarchitectonics of the bone-girdle structure and the anatomical structure of the vertebrae, deformations are considered as structural (or structural - both terms correspond to the English structural). Deformations that are not accompanied by a change in the bone-girder structure of the vertebrae are called non-structural.
The most complete etiological classification of spinal deformities, based on the works of LA Goldstein, TR Waugh (1973) and WH McAlister, GD Shakelford (1975), leads RB Winter (1995).
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