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Spinal deformities and back pain
Last reviewed: 08.07.2025
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Spinal deformity is a deviation of the spine as a whole, its sections or individual segments from the average physiological position in any of the three planes - frontal, sagittal, horizontal. Spinal deformities are the most typical clinical manifestation of vertebral syndrome and can be primary in nature, i.e. be an independent pathology, or secondary, i.e. accompany diseases of other organs and systems.
The following types of spinal deformities are distinguished:
- Scoliosis is a deformation in the frontal plane
- Kyphosis is a deformity in the sagittal plane, the apex of the arc is directed dorsally
- Lordosis-deformation in the sagittal plane, the apex of the arch is directed ventrally
- Rotation is a non-structural deformation in the horizontal plane.
- Torsion is a structural deformation in a horizontal plane. Often the deformations are mixed (polycomponent).
According to the localization of the apex, deformities are divided into craniovertebral (the apex is located at the level of C1-C2); cervical (C3-C6); cervicothoracic (C6-T1); thoracic (T1-T12), including upper (T1-T4), middle (T5-T8) and lower thoracic (T9-T12); thoracolumbar (T12 - L1), lumbar (L2-L4) and lumbosacral (L5-S1).
Depending on the location of the apex, right-sided and left-sided deformations are distinguished.
Taking into account the peculiarities of spinal curvatures characteristic of each specific disease, typical and atypical deformations are distinguished.
Given the presence of physiological curvatures of the spine in the sagittal plane, when characterizing gentle kyphotic deformations in the thoracic region, not only their absolute value is taken into account, but also their relationship with the parameters of physiological thoracic kyphosis. Gentle kyphosis is usually formed by 8-10 vertebral segments.
When quantifying pathological kyphosis (button, trapezoid and angular), the absolute value of the deformation is determined between the cranial and caudal neutral vertebrae closest to the apex. The kyphotic arc is usually formed by 3-5 vertebral segments. When estimating lumbar inversion (see terms), the actual value of the deformation is determined by the sum of the measured kyphosis and physiological lordosis.
In the presence of changes in the microarchitecture of the trabecular bone structure and the anatomical structure of the vertebrae, the deformations are considered structural (or structural - both terms are found in Russian literature, corresponding to the English "structural"). Deformations that are not accompanied by a change in the trabecular bone 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), is given by RB Winter (1995).
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