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Symptoms of scoliosis
Last reviewed: 20.11.2021
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Usually idiopathic scoliosis is first diagnosed in children 6-7 years, which corresponds to the first jump in growth. A child with scoliosis should be examined in a standing position in front, behind and at the side. When examining a child in the standing position with the legs straightened in the hip and knee joints, the asymmetry of the shoulder, front upper pelvic bones, triangles of the waist, formed by the lateral surface of the trunk and the inner surface of the upper limb are noted. When viewed from behind, the lateral deflection of the spinal cord line from the axial line is determined, as well as the asymmetry of the position of the scapula and other bone orientations. When the child is tilted forward, the asymmetry of the height of the posterior semicircle of the ribs in the thoracic region (the rib humerus or the gibus) is revealed, the paravertebral asymmetry is in the form of a muscular cushion on the convexity side of the arc of curvature in the lumbar part (Adams' positive test) caused by abnormal vertebral rotation.
Further progression of scoliosis leads to aggravation of the described symptoms, increased pelvic tilt and functional shortening of the leg on the side opposite the apex of the main arc of curvature. There is a disturbance of the biomechanics of the spine, the displacement of the center of gravity causes the inclination of the child's torso towards the curvature. An increase in the deformation of the thorax due to progressive pathological rotation of the vertebrae creates not only an undesirable cosmetic defect (rib hump), but also causes anatomical and functional changes in the internal organs: a decrease in lung volume, impaired breathing, changes in the position of the heart and vascular bundle.
Occurring with idiopathic scoliosis, anatomical and functional disorders of the spine, thorax and internal organs allow talking about scoliotic disease.
When scoliosis is detected, it is necessary to start active complex conservative treatment before the child's growth. The most critical period occurs at the age of 11-13 years, when the second growth jump occurs, and the deformation of the spine can progress rapidly.
With the development of deformity of the spine more than 50 °, scoliosis under the influence of gravity and attachment of the degenerative component of the intervertebral discs continues to progress all life - a rough deformation of the thorax develops in the form of the anterior and posterior ribs. At this point, the indications for surgical treatment are determined.
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