Spinal Curvature Disorders
The human spine curves from front to back in some areas naturally. However, when the curvature is more pronounced in some areas in an abnormal way, it is considered a disorder. This excessive curvature proves to be detrimental to the normal life of the affected person. It leads to pain as well as other debilitating symptoms, according to the severity and the abnormal curvature of the spine.
Spinal Curvatures that are Normal
There are four curves that are considered normal in every spine. The first curvature is at the cervical spine that runs down to the sacral curvature. The four curvatures are named according to the area of the spine they are found. Thus, they include:
1.Sacral curvature – It is formed by 5 sacral vertebrae
2.Lumbar curvature – It is formed by 5 lumbar vertebrae
3.Thoracic curvature–Consists of the 12 thoracic vertebrae
4.Cervical curvature – Consists of 7 cervical vertebrae
These curves are formed gradually as the baby grows. Initially, there are just 2 curvatures developed in the womb. The spine is shaped like ‘c’ when the infant is born. Only the thoracic and the sacral curvatures are developed. Slowly, in the first few months, the cervical curvature is formed and this helps the baby to lift his/her head. After about 6 months, the infant develops the lumbar curvature. This helps the baby crawl, sit as well as stand without any help.
3 Types of Spinal Curvature Disorders
The spinal curvature disorders are divided into 3 types. These abnormalities cause postural deformities.
Scoliosis is a condition where the spine is shaped like an S or C. This curvature occurs just during puberty. The spine curves side to side, causing poor muscle development as well as unbalanced posture. This condition can either be congenital or have idiopathic in nature. In some cases, it occurs as a secondary condition to an underlying condition.
About 65% cases are idiopathic in nature, that is, have unknown causes. About 15% occur as a congenital condition. Only 10% cases occur due to an underlying neuromuscular disease. Congenital scoliosis occurs in uterowhen the fetus is about 3 to 6 weeks old.
- Uneven shoulders
- Uneven waist
- Prominent shoulder blade
- One hip higher than the other
- In severe scoliosis, the spine may rotate or twist side to side. This causes the ribs one side of the body to stick out more on the other side.
- Back pain
- Problems breathing
When the spinal curvature is more than 10 degrees to the right or left, it is diagnosed as scoliosis. The patients are physically examined and the underlying cause determined. The gait is assessed to check for any other condition such as spinal bifida. The patient will be asked to bend forward as much as possible. This is called as the Adams forward bend test. Any prominence noted requires an X-ray test.
When scoliosis is suspected, a full-spine, front and back as well as side view X-rays are taken. A series of X-rays is taken over a period3 to 6 months to check for the progress of the curve. MRI may also be required. The quantitative assessment of the curvature is carried out with the help of Cobb angle.
In case of children and adolescents, the traditional methods of treatment include observation, bracing and then surgery. In case of adults, the treatment includes prescription of painkilling medications, bracing, exercise and surgery, if required. The patient is given physical therapy to regain and maintain their physical symptoms and continue their daily activities with ease. Bracing helps in preventing further curvature of the spine, especially in case of idiopathic scoliosis. Surgery is carried out if the progression is greater than 45 to 50 degrees of magnitude. Or in patients with spinal bifida and cerebral palsy. There are two types of surgeries, anterior fusion and posterior fusion. In anterior fusion, is approaching the spinal cord through an incision on the side of the chest wall and posterior fusion is incised on the back.
Also called as swayback, this condition is caused by an exaggerated inward curvature of the lumbar spine. The excess pressure on the lower back due to the excessive curvature of the spine leads to pain. The person with lordosis has a visible arch in the lower back that appears ‘C’ shape from the side. These people appear as if they are sticking their stomachs and buttocks out.
Lordosis tends to appear in childhood and is called as benign juvenile lordosis. This does not have any apparent cause. Other causes that can lead to lordosis include:
- Poor posture
- Achondroplasia, that is, a type of dwarfism
- Tight low back muscles
- Vitamin D deficiency in children
- Excessive visceral fat
The patient is physically examined and an abnormally large arch at the lower back is noted. The person will also appear to stand sticking his stomach and buttocks out. After taking a complete medical history, X-rays bone scans, MRI and CT scan, lordosis is diagnosed.
The treatment depends on the severity of the curvature as well as any other symptoms.The treatment includes use of braces, especially in children and teens. Medications are prescribed to help reduce the pain and swelling. Physical therapy helps in rebuilding the strength of the muscles, weight loss, and yoga helps in improving the strength and flexibility of the body.
Also called as a hunchback, it is the opposite of lordosis. In this condition, the upper back develops an excessive curvature. This causes the appearance of a visible hump on the upper back. From the side, you can observe the round or protruding hump. The affected person tends to have rounded shoulders and appears to slouch. It causes breathing problems and back pain. In case of old women, the appearance of the hump is called as dowagner’s hump.
There are different types of kyphosis that have different causes. In case of Scheuermann’s kyphosis, it is seen mostly in teenagers. There is no known cause for this condition and is supposed to be a genetic condition. In some people, the spinal column does not develop correctly in the womb and leads to congenital kyphosis.
Postural kyphosis is the most common type that occurs due to muscular imbalances and aging body leading to dowager’s hump. Vitamin D deficiency leading to rickets can cause nutritional kyphosis. Verterbral fractures can lead to post-traumatic kyphosis.
Physical observation, measurement of the curvature and X-rays help confirm kyphosis.
Treatment includes use of orthosis such as full body braces helps in the correction of kyphosis. Specialized physical therapy is given for lumbar kyphosis called the Schroth method. In severe cases, surgery called as kyphoplasty is carried out to prevent vertebral collapse and reduce the pain.
These are the 3 spinal curvature disorders that affect the normal living of the affected person. Any spinal deformity should be corrected as soon as possible to prevent complications and improve the daily life of the affected person. Speak to your heathcare provide for more details related to the condition affecting you.
Written by: Saptakee sengupta
Date last updated: April 07, 2015