Escoliosis: the deviation of the column

Neus Vives

1 November, 2005

Scoliosis, or deviation from the back, is a current problem that must be dealt with in the future. An early diagnosis is the main key to slowing down evolution and preventing our quality of life from deteriorating.

Humans can keep us erect, especially on the spine. But it is true that going against the gravity is paid with a expensive price since it represents the first cause of pain in society.

The spinal column, also called the rachis, ensures the static and dynamic balance and makes protective case of the spinal cord and nerve roots. It forms during the intrauterine life and it is differentiated and ossificante until it is just growing.

If we look at it in profile, we will see some curvatures that are necessary to perform its function. The same thing does not happen with the curvatures that we can detect by looking at it in front, since to work well it must be straight.

Any curvature can be a problem with more or less important repercussions in the future.

What is scoliosis?
Scoliosis is a three-dimensional deformity of the spinal column where the lateral deflection is accompanied by a rotation or rotation of the vertebrae, so that there appears a paravertebral gull (beak) and a hawk of the vertebral bodies.

We must differentiate the structured scoliosis from the school attitude. This last one is a postural deformity of the rachis, but it is not accompanied by spinal rotation or falconry of the bodies and, therefore, does not originate paravertebral "gepa". We say that in the school's attitude the curve is flexible so that we can rectify it. Most times it corresponds to a difference in length of the legs and disappears when stretching. Other times they are postural vices that the child takes in the school stage. Curves can also be observed in the spine when there is a muscular contracture. In these cases, the treatment will be to correct the cause and to make a good rehabilitation.

The cause of scoliosis is unknown in most cases (75%). Only in 10% the cause is a malformation present at birth. The rest of the cases can originate from neuromuscular diseases or others such as poliomyelitis, spina bifida, tumors or accidents. However, there are two factors that have a decisive influence on evolution: genetic predisposition and growth.

The treatment
The purpose of the treatment of scoliosis is to achieve that the bony growth ends with a deformity that does not produce a limitation in daily life and that it does not progress. It will depend, therefore, on the degree of deformity, on the age of the child and the degree of bone maturation.

Although many authors think that physical exercise and physiotherapy have no real correction effect of deformity, decades ago they have been used as complementary therapies that have many benefits for those affected by scoliosis.

In this sense, kinesitherapy exercises (back school) and therapeutic swimming are excellent tools to compensate for deviations as they improve muscle tone, correct postural imbalances, increase flexibility and improve breathing.

Orthopedic treatment with corsets or plaster is used especially with those young people in the growth stage that have a curvature between 20 and 45 degrees. In adults, an option is surgery, which is especially indicated if the deviation produces a lot of pain, respiratory problems or, simply, for aesthetic questions.

TYPE OF SCHOOLS

According to age:
Kids Meal: before three years. It is very serious since, when the infant grows, the curvature can be aggravated to the 100 degrees.
Youth: from 3 to 10 years. It is very risky to evolve ..
From the teenager: from 10 to 18 years. It is the most frequent and usually appears in the girls after the first rule and in the boys at the end of puberty.
Adult: it can be scoliosis originated in childhood that has not been treated. It can also be degenerative or traumatic.
According to location:
Dorsal: the most frequent In adults, it can cause cardiorespiratory problems.
Dorsolumbar: A single curve or a double curve that balances and produces less aesthetic alteration may appear.
Lumbar: it is severe and can cause osteoarthritis in adulthood.

the author

Neus Vives

Head of the Health Department of Claror Cartagena

Medical specialist in Physical Education and Sports Medicine (UB)

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