척추측만,일반적으로 알려져 있으로 척추,입체 기형 척추의 포함에 이상이 코로나,화살 및 축 비행기가 있습니다. 정상적인 척추,본 뒤에서 나타나야 하며 직선으로 대칭의 측면 트렁크가 있습니다.
척추측만,일반적으로 알려져 있으로 척추,입체 기형 척추의 포함에 이상이 코로나,화살 및 축 비행기가 있습니다. 정상적인 척추,본 뒤에서 나타나야 하며 직선으로 대칭의 측면 트렁크가 있습니다. 는 경우에,정면에서 볼,어깨는 고르지 못한 경우,또는에서 본 뒤,다시는 고르지 않은,척추어야한 의심. 이 경우,서 full-spine X-ray 촬영 될 수 있습니다. 전면 X-ray 여 측면의 곡률이 10 도 이상,척추 수 있는 진단을 받았습니다. 온화한 척추는 일반적으로 발생하지 않는 명백한 불편함이 없는 명백한 육체적인 기형입니다. 더 많은 심각한 척추에 영향을 미칠 수 있습의 성장과 발전을 유아 및 청소년의 원인,물리적인 기형입니다. 심한 경우에,그것은 영향을 미칠 수 있는 심폐 기능도 포함한 척수 원인,마비됩니다. 온화한 척추 관찰할 수 있는 동안 심한 경우에는 수술 치료가 필요 합니다. 척추측만증은 일반적인 질병에 영향을 미치는 청소년과 어린이며,조기 감지 및 치료는 매우 중요합니다.
Etiology
Scoliosis is a symptom, and many factors can cause it, each with its own characteristics. For effective treatment, it’s essential to identify the type and treat accordingly.
Scoliosis can be classified into functional and organic types, also known as non-structural and structural scoliosis.
(I) Non-structural Scoliosis
1. Postural scoliosis;
2. Lower back and leg pain, such as from herniated discs or tumors;
3. Lower limb length discrepancy;
4. Hip joint contracture;
5. Inflammatory stimulation (such as appendicitis);
6. Hysterical scoliosis.
Non-structural scoliosis refers to temporary scoliosis caused by certain factors. Once the cause is removed, it can return to normal. However, long-term non-structural scoliosis can develop into structural scoliosis. In general, the scoliosis in these patients disappears spontaneously when lying flat, and X-rays show normal vertebrae.
(II) Structural Scoliosis
1. Idiopathic
The most common type, accounting for 75%–85% of all cases. The cause is unclear, hence the name idiopathic scoliosis. Based on the age of onset, it can be divided into three categories:
(1) Infantile type (0–3 years): ① Spontaneously curable type; ② Progressive type.
(2) Juvenile type (4–10 years).
(3) Adolescent type (>10 years to skeletal maturity).
Of the three types, the adolescent type is the most common.
2. Congenital
(1) Dysformation type: ① Congenital hemivertebrae; ② Congenital wedge-shaped vertebrae.
(2) Segmentation dysplasia type.
(3) Mixed type, combining the above two types.
Congenital scoliosis is caused by incomplete segmentation of the vertebrae during embryonic development, the presence of bony bridges on one side, incomplete development of one vertebral body, or a combination of both, resulting in asymmetrical growth of the two sides of the spine and thus causing scoliosis. It is often accompanied by other malformations, including spinal cord malformations, congenital heart disease, and congenital urinary tract malformations. These spinal developmental abnormalities can usually be detected on X-rays.
3. Neuromuscular Scoliosis
This can be divided into neurogenic and myogenic types. It is caused by imbalances in muscle strength due to neurological or muscular diseases, particularly asymmetry in the paravertebral muscles, leading to scoliosis. Common causes include sequelae of poliomyelitis, cerebral palsy, syringomyelia, and progressive muscular atrophy.
4. Neurofibromatosis with Scoliosis
5. Scoliosis Caused by Interstitial Lesions
Such as Marfan syndrome and congenital polyarticular contractures.
6. Acquired Scoliosis
Symptoms such as those caused by ankylosing spondylitis, spinal fractures, spinal tuberculosis, empyema, and thoracic surgeries.
7. Other Causes
Symptoms such as those caused by metabolic, nutritional, or endocrine factors.
Diagnosis
(I) Early Diagnosis of Scoliosis
Early detection and treatment are crucial to prevent the deformity from worsening. Early signs of scoliosis include: uneven shoulders, deviation of the spine from the midline, one scapula higher than the other, skin folds on one side of the chest, and asymmetry of the back when bending forward. Early detection relies mainly on parents, teachers, and school doctors. A simple examination is the bending test: Have the child remove their shirt, stand upright with both feet flat on the ground. Place their hands together between their knees and gradually bend forward. The examiner sits in front of or behind the child, looking straight ahead, and observes whether both sides of the child’s back are at the same height. If one side is higher, it indicates a possible scoliosis with vertebral rotation causing a bulge. If the flexion test is positive, you should seek medical attention promptly.
(II) Imaging Examinations
(1) X-ray Examination: This is the most important. X-rays can generally differentiate the cause, classification, curvature, location, rotation, bone age, and compensation degree of scoliosis.
Routine X-rays should include standing full-length anteroposterior and lateral views of the spine, including the lower cervical vertebrae at the upper end and the bilateral lumbosacral joints and iliac wing at the lower end. Other special X-rays include supine lateral bending views and traction views, which can assess the flexibility of scoliosis.
(2) CT Scan: This can effectively display bony deformities, especially 3D reconstruction CT of the spine, which can clearly show congenital vertebral deformities. Myelography CT scans can also be performed, which can clearly show the relationship between the spine and nerves in some complex spinal deformities, and whether there is spinal cord malformation, guiding surgical treatment.
(3) Magnetic Resonance Imaging (MRI): Compared to myelography, this is a non-invasive examination with high soft tissue resolution, which can effectively display spinal cord lesions.
(III) Neurological Examination
A detailed and comprehensive neurological examination should be performed on every patient with scoliosis. On the one hand, attention should be paid to whether the scoliosis is causing spinal cord compression, resulting in paraplegia, and whether there are hyperactive tendon reflexes and pathological reflexes in the early stage. On the other hand, attention should be paid to whether there are any spinal cord abnormalities such as myelomeningocele, spinal cord diastasis, and syringomyelia.
