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Kyphosis of the thoracic spine – this is its curvature in the anterior-posterior plane. The curvature can be both pathological and physiological. In the thoracic region, kyphosis develops most often, although cases of the formation of both cervical and lumbar kyphosis are described in the medical literature.
The disease is manifested mainly by pain that occurs in the place where the curvature occurred. Many factors lead to kyphosis, including: hereditary predisposition, injuries, incorrect posture taken by a person during work or study, weakness of the back muscles, etc. Kyphosis, as a rule, does not pose a threat to human life and is treated conservatively, but surgical intervention is not excluded .
Physiological kyphosis of the thoracic spine is present in all people. Pathology is spoken of when the bend exceeds an angle of 45 ° C. Often kyphosis is combined with scoliosis of the spine.
Statistics indicate that up to 10% of people worldwide live with kyphosis of varying degrees of severity. Male children and adolescents are more susceptible to it.
Interestingly, in ancient times, people with a hump were treated as representatives of an evil force and were often afraid of them. However, now there is no doubt that there is nothing mythical in this disease.
Symptoms of kyphosis of the thoracic spine
It is a mistake to believe that the symptoms of kyphosis of the thoracic spine are manifested only in stoop or the presence of a hump.
In the body, due to the curvature of the spine, changes invisible to the eye will occur:
The volume of the chest and lung capacity becomes smaller, which does not allow the patient to take a full breath.
The diaphragm gradually descends and begins to put pressure on the internal organs, which leads to disruption of their work.
As kyphosis progresses, the patient develops compensatory hyperlordosis in the lumbar and cervical regions.
The height of the intervertebral discs decreases at a faster rate, compared to how it would happen with the natural aging of the body. The cushioning capacity of the disks suffers.
Pinched roots of the spinal cord leads to a violation of the innervation of the upper and lower extremities.
The redistribution of the load on the intervertebral discs becomes the impetus for the development of osteochondrosis.
Objective complaints presented by patients with thoracic kyphosis:
Rapid fatigue of the back muscles;
Pain in the upper back;
Numbness and weakness of the hands, a feeling of “goosebumps” on the skin;
From the digestive tract – lack of appetite, belching, stool incontinence, or constipation;
On the part of the respiratory system – shortness of breath, an increase in bronchitis, which differ in severity and may culminate in pneumonia;
Disorders in the work of the cardiovascular system – an increase in blood pressure, tachycardia.
Depending on the nature of the thoracic kyphosis, the appearance of a person changes. So, with angular kyphosis, a hump appears, the body becomes shorter, the chest protrudes forward. With arcuate kyphosis, the entire thoracic spine is deformed, the patient’s back takes the form of the letter C.
Causes of kyphosis of the thoracic spine
The causes of kyphosis of the thoracic spine are multiple, among them:
Violations of intrauterine development that occur at the stage of formation of the vertebrae in the embryo. In 13% of cases, kyphosis is combined with other anomalies in the development of the spine, when cysts, constrictions, abnormal spinal roots, etc. are found in the child.
Poor heredity (Scheuermann-Mau disease).
Past trauma is the most common cause of thoracic kyphosis. The risk of developing the disease directly depends on how severe the injury was.
Paralytic kyphosis is formed as a result of paresis and paralysis of the spinal muscles in cerebral palsy and poliomyelitis.
Surgical interventions on the spinal column.
Hypodynamia.
Compression fractures of the thoracic vertebrae, which are often observed in old age, mainly in women.
Non-infectious diseases (tumors of the spine, Bechterew’s disease, spondylitis).
Radiation therapy for the treatment of malignant neoplasms. In this case, children are at risk. In adults, kyphosis does not develop after such exposure.
Weak development of the back muscles.
Rickets suffered in childhood.
Incorrect body position during study or work.
Psychological factors. For example, the disease may develop as a result of the fact that a teenager is ashamed of his high growth and consciously stoops.
Degenerative changes in the spinal column due to osteochondrosis and osteoporosis.
Diagnosis of kyphosis of the thoracic spine
Diagnosis of kyphosis of the thoracic spine is the responsibility of an orthopedic surgeon. To begin with, the patient is interviewed, after which the doctor examines him. It is important to clarify the features of pain, their localization, the presence of neurological disorders. During the examination, the orthopedist palpates the neck and back, clarifies muscle strength and skin sensitivity. In addition, the doctor listens to the heart rhythm and lungs, evaluates tendon reflexes using a specialized set of tests.
The next stage of the study is an X-ray of the spine. Most often, it is performed in several projections (frontal and lateral), and targeted shots are also taken in non-standard projections, for example, during spinal stretching.
If there is a suspicion of pathological changes in soft tissues, then the patient is shown an MRI. Computed tomography is performed to clarify certain violations of the bone structures.
Treatment of kyphosis of the thoracic spine
Treatment of kyphosis of the thoracic spine is most often conservative. The patient is recommended to perform exercise therapy, which allows you to strengthen your back muscles, visit a massage and physiotherapy room. Sometimes the help of a chiropractor is needed. Corsets are selected individually, they are more designed to reduce pain. You should not wear a corset regularly, since these devices will not help correct your posture, but they can weaken your back muscles. This, in turn, will lead to the progression of the disease.
Implementation of the exercise therapy complex
A properly selected complex of physiotherapy exercises can completely save a person from the disease. Especially performing exercises is effective in childhood, until the spine has completed its growth and formation.
However, adults should not ignore medical complexes. Thanks to regular exercise, you can strengthen your back muscles, normalize blood circulation, and stop the progression of the disease.
There are many sets of exercises. It is better if they are compiled by the attending doctor on an individual basis, depending on the angle of inclination of kyphosis, on the age of the patient, and on the presence of concomitant diseases. In addition, it is important to eliminate the immediate cause that led to the curvature of the spinal column.
Massage for the treatment of thoracic kyphosis
Massage will be effective if combined with gymnastic complexes. It must be done by a professional. If there is no opportunity to visit a massage parlor, then it is important that the technique of its implementation is strictly observed. This will not harm the patient and not worsen the course of kyphosis.
You must follow the following rules:
Movements should be light and smooth.
The back muscles should be relaxed. The position that the patient takes should be chosen as comfortable as possible.
Do not put strong pressure on the curved part of the spine.
The skin of the back should not be damaged.
Massage those vertebrae that noticeably protrude from the skin, you need to be careful.
Surgical treatment of the disease
Surgery is performed according to the following indications:
Pain that is not controlled by drug therapy and other conservative methods.
Accelerated progression of kyphosis, combined with neurological disorders.
Kyphosis affects the functioning of the heart and lungs.
Kyphosis is a cosmetic defect that worsens the quality of a person’s life and interferes with his work activity.
There are also contraindications to surgery, including:
old age.
Arterial hypertension of the third stage, arrhythmia, diabetes mellitus and other diseases.
Oncological diseases.
The task facing the surgeon is to correct the angle of inclination of the spinal column and stop the progression of the disease. It is important to eliminate the clamping of the nerve endings, as well as to prevent their compression in the future. Surgical intervention on the spinal column is complex and requires high qualification on the part of the doctor. It is mandatory to perform general anesthesia and careful preliminary preparation of the patient. Often one operation is not enough.
To fix the spine in the desired position, a variety of designs are used. Modern materials are titanium and titanium nickelide. Prostheses made from them are not rejected by the body and can stay in it for many years without any consequences.
There are two methods by which surgery is performed:
Osteotomy with the intersection of the bones and further plasty. During the operation, the curved vertebrae are cut, the existing deformities are corrected, and then they are fixed in the correct position. Cracks that are formed as a result of corrections of the vertebrae are filled with various materials. This can be donor bone, artificial grafts, or bodily fluids. The final stage of the operation is the fixation of the spinal column with titanium screws or other structures. This method is highly effective for severe kyphosis of the thoracic spine.
A less invasive procedure is kyphoplasty. The procedure for restoring a destroyed vertebra is performed through small incisions that are made at the site of injury. All manipulations are performed using endoscopic equipment. In the place where the destroyed vertebra is located, the surgeon inserts a capsule that swells and takes the form of a defect. Then the capsule is filled with a special hardening solution. This allows you to create a structure that will not allow the spine to collapse. This operation will be effective for minor injuries of the spinal column, as well as for recent injuries.
Prevention of kyphosis is to control posture. The posture while working at the computer, while studying at school, while doing homework, must be correct. If parents notice that their child has begun to stoop, then this is a reason to contact an orthopedist.