20.04.2024

Classification, diagnosis and treatment of paralytic scoliosis

Scoliosis – a large complex of symptoms, which is based on pathological changes in the spine and surrounding soft tissues. In the diagnosis of the disease even to the naked eye you can see the fixed curvature of the spine, which as the disease becomes more and more.

Scoliosis can be congenital or acquired, but often to understand the reason why it is very difficult, and then we can talk about the idiopathic form, which is the most common.

As for paralytic scoliosis, it usually begins to form after suffering childhood polio. The first manifestation can be seen in the recovery period due to the fact that there is a imbalance between the completely paralyzed muscles and the muscle tissue, which innervation is either preserved or have been restored in the result of the treatment.

In very rare cases, the first symptoms can be observed and in the midst of disease that occurs when paralysis of the deep muscles of the spine. And this becomes the cause of several arcs of curvature.

Classification

The classification depends on the causes of pathology:

  1. 5% of all cases of paralytic scoliosis occurs against a background of widespread paralysis of the muscle.
  2. In pathological location of the pelvis that is often seen in post-polio. While using research, you can identify quite heavy changes in the muscles of the lumbar and pelvic region. They develop in 23% of all patients who have had polio. Lateral curvature in this case can reach 65 degrees or more.
  3. Contractures in the hip joints as flexor and extensor. The incidence of 9%.
  4. Paralytic scoliosis of the upper spine with paralysis of the muscles of the shoulder girdle. One of the rarest forms, and found only one and a half percent.
  5. Mixed or atypical forms that also occur in one and a half percent of all cases.

Other forms of curvature of the spine often have their own classification which differs from that presented in this case.

The clinical picture

If the disease is only beginning to develop, any complaints the patient has very rare. As soon as the curvature will progress, these complaints will be greater, and the defect can be seen with the naked eye.

The first symptoms of illness can be attributed to the heaviness and fatigue in the back, aching pain, even after slight physical exertion. In more severe cases begin to appear disorders in the internal organs – heart, vessels, lungs, organs of the pelvis. And finally, this is a visible cosmetic defect, which can cause depression.

Also, the clinical picture will depend on what the spine was damaged. This can be the chest, the waist or the combined variant, with involvement in the pathological process of both departments.

Also, scoliosis may be stable for a long period of time when a person does not happen any changes, and progressive, in which changes in the curve of the back and the vertebrae are seen to the naked eye.

Diagnosis

As paralytic scoliosis occurs primarily after poliomyelitis, children who transferred this disease remain at risk for almost all life. Therefore, the examination of these patients should be carefully.

The survey should be carried out by x-ray, CT or MRI apparatus. It should be done not only lying, but standing and sitting. This helps to identify the initial signs of the disease at an early stage.

Conservative treatment

On the first and second stages assumes conservative treatment – massage, physiotherapy, exercises, wearing a corset. If the disease will rapidly develop further, then in the third and fourth stages possibly surgery, which is carried out under strict indications, taking into account the patient’s General condition and its health.

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