Treatment of cervical scoliosis. Curvature of the cervical spine Neck curvature of this type is observed

Today, many people know what scoliosis is. This disease in Lately has become widespread all over the world. Often, the curvature of the cervical spine leads to a violation of the state of the body and the activity of organs and systems.

Pathology can develop at any age, it provokes spinal deformity, occurs in 45% of all diseases of the musculoskeletal system. Scoliosis is much more common in women than in men. The reasons for its formation are ambiguous, presumably the development of the disease can be influenced by trauma, which was received in childhood.

Cervical scoliosis is a curvature of the spinal column along vertical plane to the left or right side in its cervical region (from the first to the seventh vertebra).

The disease is dangerous because it provokes a violation of the blood supply to the brain due to squeezing of the artery.

The disease can appear at any age, most often it occurs in children who are over ten years old.

In medicine, scoliosis of the cervical spine can manifest itself in the following forms:

• Congenital scoliosis develops in prenatal period when part of the spine is not fully formed or appears sharp corner, which will progress as the child grows;
• Idiopathic curvature of the neck develops from birth until the child stops growing. This pathology appears for unknown reasons, which makes it difficult to treat;
• Neurogenic scoliosis appears as a result of impaired activity nervous system;
• Statistical scoliosis appears due to abnormal development of the limbs;
• Dysplastic scoliosis is characterized by lateral curvature of the spine due to metabolic disorders in its tissues and discs, as well as torsion.

The congenital form of the pathology is rare. In most cases, the symptoms of the disease begin to appear during adolescence. In 80% of cases, the causes of scoliosis have no scientific explanation.

The disease has several degrees of severity:

1. Scoliosis of the cervical spine of the 1st degree is characterized by a lowered position of the head and contracture of the shoulders due to curvature of the spine up to ten degrees;
2. The second degree is determined by the presence of an angle of curvature from ten to twenty-five degrees. At the same time, torsion is observed, asymmetry of the neck line, which is visible at any position of the body;
3. The third degree, in which the bending angle is from twenty-five to forty degrees. A person has a pronounced torsion, muscle contracture, and all the signs that are inherent in the second degree of severity are also observed;
4. Scoliosis of the cervical spine of the fourth degree of severity is characterized by a curvature of the spine by more than forty degrees. At this stage, the muscles in the pathological area are stretched, the symptoms of the disease increase significantly, and there is a violation of the activity of the vascular and nervous systems.

Reasons for the formation of scoliosis of the neck

There is no exact cause of the appearance of pathology in medicine. There are several theories according to which the disease can develop:

1. Endocrine dysfunction is considered to be main reason the appearance of curvature of the spine in the neck. During adolescence, a hormonal restructuring of the body occurs, which affects the development of the skeletal apparatus, making it more plastic. Therefore, the spine can change under the influence of loads;
2. Violation of the development of muscle tissue and ligaments with the accelerated growth of the child. In this case, the ligaments and muscles become weak and cannot hold the spine in a certain shape;
3. A change in bone tissue that leads to the development of dysplasia;
4. Violation of the activity of the nervous system, which leads to the appearance of syringomyelia and spinal deformity.

Also, scoliosis of the neck can appear at birth due to a violation of intrauterine development.

Today, children spend a lot of time sitting at a PC monitor, they practically do not engage in physical activity. This can cause curvature of the spine in the cervical region.

Symptoms and signs of scoliosis development

The curvature of the cervical vertebrae disrupts the composition and structure of the spine, which leads to its deformation and disruption of the functioning of organs and systems. In the first two stages of the pathology, there are no symptoms of the disease, the patient does not present any complaints.

At the third stage of the development of the disease, an asymmetry of the position of the head and the contour of the shoulders is observed, while it can be seen that the human ears are at different distances relative to the horizontal line. In a severe case, cervical scoliosis manifests symptoms in the form of a violation of the formation of the bones of the skull. These phenomena are accompanied by headaches, weakness and dizziness, the development of insomnia, memory impairment and mental retardation.

Nerve reflexes weaken over time, there is pain in the neck, which becomes worse during coughing or sneezing, the occipital muscles are in constant voltage, the limb from the side of the curvature becomes numb. With deformation of the bones of the skull, scoliosis of the thoracic region may develop.

The symptomatology of the pathology manifests itself in the last two stages of the disease, so it is important to diagnose it on initial stage development in order to avoid negative consequences in the future.

Curvature of the spine in the cervical region can lead to disability, the development of paresis or paralysis of the limbs. This is often due to compression of the blood vessels and nerves in the spine. This pathology must be treated, as it does not go away on its own.

Diagnostic measures

Before correcting the curvature of the cervical spine, the doctor must make a diagnosis. Diagnosis of the disease begins with a study of the anamnesis and examination of the patient. To determine the curvature of the spine, the patient must lean forward, while lowering his hands.

The doctor examines the line of the vertebrae, the asymmetry of the body and the presence of curvature. An x-ray is prescribed to make an accurate diagnosis. This method also allows you to identify the degree of the angle of curvature to determine the stage of development of the pathology.

Often, the doctor prescribes CT and MRI for a more detailed study of the problem. Additional research methods are used to determine the degree of damage to internal organs, blood vessels and nerves.

Treatment of pathology

Scoliosis of the cervical spine treatment involves a complex. The choice of method of therapy depends on the degree of damage to the spine, the form of the disease and general condition organism.

Conservative treatment is aimed at correcting posture, stopping the pathological process in order to prevent the use of surgical intervention. For this purpose, various methods are used:

• Manual therapy is used to relieve pain, restoration of the shape of the spine;
• Acupuncture to stop the inflammatory process;
• Massage to normalize blood circulation, relieve swelling and improve the metabolic process;
• Tszyu therapy is used to normalize blood flow and tissue nutrition, as well as to supply oxygen to the brain;
• PRP therapy is modern method designed to activate the processes of bone tissue regeneration, restore the activity of organs and the musculoskeletal system;
• Electrical stimulation of muscle tissue in the affected area.

Also, the doctor prescribes wearing a corset, proper nutrition and sleep on a hard mattress, exercise therapy and gymnastics, as well as hardening.

Medications are not used in the treatment of spinal curvature. The doctor can only prescribe painkillers for pain relief, as well as calcium and phosphorus.

In some cases, scoliosis of the cervical spine treatment involves surgery. The operation is performed in the absence of the effect of conservative therapy, as well as in advanced forms of the disease and the presence of severe unbearable pain. In this case, the following methods can be used:

1. Surgery to stop the growth of the vertebrae, in which the plate and disc are removed from the side that protrudes;
2. Stop curvature of the spine. For this, a bone graft is used, which is placed between the vertebrae to immobilize them;
3. Surgical intervention to eliminate a cosmetic defect.

In some cases, the operation can provoke the development of serious complications in the form of disruption of the vascular system, damage to the spinal cord, destruction of the vertebrae, and the development of purulent inflammation.

After the surgery, three months must pass before the bones grow together. The doctor prescribes a plaster cast and wearing a corset to support and strengthen the back. After five weeks, the patient should visit a rheumatologist for joint classes in order to restore the spine. These classes usually take place three times a week for two months. After rehabilitation, the patient must limit physical activity for the rest of his life.

Scoliosis of the cervical spine is treated in many ways, but it is best done on early stage development of the disease or prevent its occurrence at all.

Forecast and prevention

The prognosis of pathology is most often favorable. In severe cases, disability may develop.

Curvature of the neck, or torticollis, is manifested by tilting the head with turning it to the side. This condition occurs due to the pathology of the bones of the cervical spine, neuralgia, or soft tissue damage.

The curvature can be acquired or congenital. This condition is extremely dangerous, as it leads to deformities of the bones of the skull and disruption of the central nervous system. In other words, the curvature of the spine of the neck is the cause of dementia, developmental delays, impaired memory, vision, hearing, and other conditions. Therapy of the disease depends on the causes that caused it, the age of the patient, his general condition and other factors.

Torticollis in children

The curvature of the neck in a child most often begins during fetal development.

The reasons may be infectious diseases suffered by the mother, the position of the child's body in the uterus, or abnormalities in the pelvic bones of a pregnant woman. It happens that the curvature is the result of a chromosomal mutation. Types of disease:

1. Curvature of the neck of idiopathic origin. The very name of the pathology suggests that the cause of its occurrence is unknown. True, the force of curvature is extremely small and the position of the head is not fixed. There is a hypothesis that such an influence is a consequence of the position of the body in the womb. However, this form can also be with a clear complication, for example, perinatal encephalopathy.
2. If in the process of formation the sternocleidomastoid muscle has become denser or shortened, then myogenic torticollis may appear. The reason for this situation with the neck is usually the long position of the child across, that is, he pressed his head against the bones of the pelvis for a long time. With this pathology, the child's head remains motionless, as the muscles thicken and cause pain when moving. In the future, he may develop scoliosis of the spine, the skull is bent, the eyes occupy different heights on it, and the work of the brain is disturbed.
3. The curvature of the neck in infants can be the result of underdevelopment of the cervical vertebrae or their fusion into one bone. This phenomenon is called osteogenic pathology. The head is set very low on the shoulders and loses the ability to turn. Usually, the pathology is not limited to the cervical region, most often the lumbar region also loses mobility.
4. With the neurogenic component of the pathology, not only the neck is turned to one side, but half of the entire body (leg and arm is bent) is skewed to one side. In general, the child can move, but at rest, the muscles take their usual position and the curvature returns.
5. With arthrogenic torticollis, there is a congenital defect of the cervical vertebra, namely, its rotational dislocation.

Torticollis in adults

A curvature of the neck can occur at any age. It is usually caused by physical trauma. Such damage to the cervical vertebrae is also called acquired, because it can also occur in infancy, for example, on the first day of life as a result of a birth injury, for example, when strangulated by the umbilical cord. As the child matures, they may fall prey to an infection or cold, which also leads to the curve. Possible positions of the curvature of the neck in adults in the photo below.

The causes of the curvature of the cervical vertebrae may lie in the following:

1. Adjusting torticollis the child acquires with a long uncomfortable position of the head in the crib. Pathologies of soft tissues or bones in this case are not observed.
2. Reflex curvature of the neck becomes the result of various pathologies, for example, otitis media or inflammation of the ear. They cause severe pain, which causes a person to involuntarily bend his head towards the affected ear. Also, involuntary curvature is caused by purulent abscesses on the neck with mastoiditis and other similar diseases.
3. With a compensatory curvature of the neck, the patient tries to compensate for the absence of an eye, strabismus, labyrinthitis (disease inner ear). Such a half-turn allows you to increase visibility or reduce dizziness.
4. Traumatic neck injury is usually a fracture. This phenomenon is extremely painful for the patient. Causes pain not only the position of the head, but also an elementary attempt to touch the injured area. Such an injury may not be accompanied by a fracture of the vertebrae, that is, be the result of a dislocation, but the symptoms remain the same: severe pain and inability to move.
5. Several factors can lead to a traumatic phase at once. infectious diseases: syphilis, osteomyelitis, All this can easily lead to a fracture and curvature of the neck.
6. Torticollis can be the result of myositis, inflammation of the muscles, as well as inflammatory processes in the lymph nodes of the neck, in its ligaments and soft tissues, chest and spine.

Diagnosis of pathology

How to correct the curvature of the neck, the doctor decides only after an accurate diagnosis. One glance at the patient is not enough for the diagnosis, although the curvature looks quite characteristic. In order to understand why the child has a curved neck, the doctor conducts a survey of the mother about how the pregnancy and childbirth proceeded. Whether deviations in analyzes on hormones were fixed. It also matters how the baby was born (already with a curvature or it came later). The patient must be examined by a neurologist.

For an accurate diagnosis, modern instrumental methods, computed tomography or magnetic resonance imaging are used. If this is not possible, then a method such as radiography fully justifies itself.

We should not forget that in case of associated diseases, it will be necessary to consult with specialized specialists, for example, with strabismus, you should visit an ophthalmologist, with syphilis - a venereologist, sometimes even a psychiatrist may be needed.

Treatment of pathology

The treatment of neck curvature is the most diverse, the choice of method depends on the type and severity of the pathology. Sometimes conservative or physiotherapeutic treatment is sufficient, and sometimes surgery cannot be dispensed with.

Physiotherapy includes electrophoresis with the use of various drugs (lidase, potassium iodide). Irradiation of the affected area of ​​​​the neck with ultraviolet rays helps well. Most often, however, therapeutic massage is used, especially for newborn patients.

The patient is also taking a number of medications. various action. The treatment regimen includes pain medications, antibiotics, muscle relaxants, or anticonvulsants.

Typically, treatment with these methods takes at least 6 months, subject to their regularity and correctness.

If such treatment is ineffective or there is an injury, then a surgical operation is performed. It can affect muscles, ligaments, and even bones.

After the operation, the patient must wear a special cervical corset for some time, which holds the cervical vertebrae in correct position.

Therapeutic exercises and position

For young children, the most effective and painless method of treatment is gymnastics. It is useful not only for the neck, but for the entire developing organism. It is easy to do, anyone can do it after a few sessions with a physiotherapist.

To stretch the muscles of the neck, you need to put the baby on the table so that his head hangs over the edge. In no case should you let her out of your hands. It is necessary to very slowly and gradually lower your hands with the baby's head to the edge of the table, and eventually beyond its edge. So the muscles will gradually stretch without ruptures and injuries.

For the same purpose - stretching the muscles, it is necessary in the prone position to turn the baby's head in one direction or the other. Muscle stretching can also be done in an upright position, holding the baby in your arms and holding his head.

Forecast

In general, the prognosis for neck curvature is positive. Timely therapy, even if it is a surgical operation, restores the cervical vertebrae and soft tissues in full. The only exception is the Klippel-Feil syndrome, in which the bones of the cervical spine turn into a monolith.

Consequences

If the curvature of the neck is left without timely treatment, then a person may experience dangerous conditions, sometimes incompatible with life.

In addition to a visually unaesthetic appearance, which in itself causes psychological trauma in a child, systemic disorders may also occur. For example, mental retardation, impaired vision, hearing, pathology of the musculoskeletal system. And if the patient has a clamping of the trachea, then pulmonary insufficiency and general oxygen starvation develop.

Prevention

To prevent congenital curvature of the neck, the expectant mother must comply with preventive measures. She should definitely be observed by the district doctor throughout her pregnancy, take tests and undergo all necessary procedures. In this case, it will be possible to diagnose the pathology at the very beginning and easily cure it. During pregnancy, you should not eat foods containing preservatives and dyes. You should not smoke or drink alcohol.

To prevent injuries that cause neck curvature, it is necessary to observe safety precautions at work and in sports, and in case of injuries, immediately consult a doctor.

Orthopedics

A separate topic of prevention is orthopedics. Not only the condition of the neck, but also the whole organism depends on how the head lies during sleep. Therefore, the pillow should not be hard or soft, the head should rise 5-7 cm above the mattress. Canvas bags with salt or buckwheat husks are great for newborns. Pillowcases should be made of fabric that absorbs sweat easily.

Conclusion

The curvature of the neck cannot be left without treatment, because the pathology is fraught with serious consequences, sometimes irreversible. At the first signs of the disease, you should immediately consult a doctor. In most cases, the prognosis is favorable.

The configuration of the neck changes with an increase in lymph nodes, salivary glands, with tumors of soft tissues, nerves, spine, carotid, thyroid glands, aberrantly located goiter, diverticula of the pharynx and esophagus, aneurysms of the vessels of the neck, subcutaneous emphysema, hematomas, abscesses and phlegmon, developmental anomalies, tumors of the mediastinum.

A peculiar deformation - a thick neck with a cone downwards (Manuylov's symptom) - is observed with the cervical ribs.

Deformation of the neck, pain occurs with inflammation of the salivary glands - sialoddenosis. Outwardly, it resembles the swollen cheeks of a hamster.

Neck deformity occurs with a systemic increase in the salivary and lymphatic glands and is accompanied by a decrease in salivation. Splenomegaly is characteristic.

Shortening of the neck ("a man without a neck"), restriction of movements occur when soldering underdeveloped vertebrae (Klippel-Feil syndrome), as well as with normal synostosis. In the first case, there is also a downward displacement of the hair growth boundary.

"Lord's posture" is characteristic of osteochondrosis, trauma to the spinous processes. Fixation of the neck in the reduced position occurs with torticollis (congenital or acquired deformity) associated with fibrosis or shortening of the sternocleidomastoid muscle.

A typical congenital deformity is also the pterygoid neck - the formation of triangular sail-like folds on its lateral surfaces. Pterygoid folds of the skin in the neck are combined with the same folds in the joints, swelling of the extremities, and other malformations.

A symmetrical increase in the neck occurs with systemic tumor lesions of the salivary glands, diffuse disease of the thyroid gland, lymph nodes (lymphosarcoma, lymphogranulomatosis, sarcoidosis, blood diseases), subcutaneous emphysema, myxedema, and obesity. The accumulation of lymph nodes deforms the neck either at the root, or in the submandibular, parotid regions, along the sternocleidomastoid muscle. Palpation examination reveals all the characteristic signs of altered lymph nodes. The smoothness of the typical contours of the neck in the median triangle also occurs with diffuse enlargement of the thyroid gland.

Subcutaneous emphysema leads to the expansion of the contours of the neck mainly at the base and is often combined with mediastinal emphysema, and crepitus is characteristic on palpation; in the anamnesis it is possible to identify the trauma or endoscopic examination.

Asymmetric neck deformities are formed with nodular goiter, pathology of the lymph nodes, aneurysms, tumors and cysts. Pulsation is often visible - direct with aneurysms, transmission - with tumors and diseases of the lymph nodes. The disappearance of the pulsation of the artery under the tumor is a sign of its malignancy. Tumor-like deformity of the neck most often occurs with an increase in lymph nodes with a characteristic swelling in the projection of the lymphatic collectors of the neck.

Limited deformities along the sternocleidomastoid muscle occur with aberrant goiter, aneurysms of the vessels of the neck, and tumors of the carotid gland. Carotid tumors do not move vertically, and blood pressure often rises after palpation.

Clear, rounded formations in the area of ​​the hyoid bone, as a rule, turn out to be median cysts. If the cyst is small, it is somewhat displaced from the hyoid bone, when the head is tilted back, a cord is visible going from the cyst to the bone. Pulsating masses are usually aneurysms. Patients feel noise in the head, throbbing pains.

Behind the vertical branch of the lower jaw, tumor-like deformities occur with a tumor, less often a cyst or inflammation of the parotid salivary gland. Chronic deformities are caused, as a rule, by a tumor, acute - by mumps. The neck is asymmetrically deformed in the upper half and with woody phlegmon of Chasignac, which is accompanied by sharp pain, dysphagia, intoxication, the skin is hyperemic, with a cyanotic tint.

Scoliosis is a deformity of the spine in several planes around its axis. It occurs in any of the spine: from the lumbar to the cervicothoracic.

Curvature of the cervical spine is also called "high scoliosis". This disease is much more typical for women, it occurs in them 3 times more often than in men. Occurs in childhood. Therefore, parents should consider correct staging diagnosis and treatment as early as possible.

This will help your child avoid neck and back problems as an adult.

However, if the curvature is already present in an adult, this does not mean at all that the treatment is already too late: it is necessary to start correcting posture and head position at any age when there are problems with this and a final diagnosis is made.

For the prevention and treatment of DISEASES OF THE JOINTS, our regular reader uses the method of non-surgical treatment, which is gaining popularity, recommended by leading German and Israeli orthopedists. After carefully reviewing it, we decided to offer it to your attention.

Causes of curvature in the cervical spine

There are two types of scoliosis: congenital and acquired. Congenital - associated with birth injuries and requires a special approach to treatment, depending on the nature of the injury.

Acquired curvature does not have any one specific cause. As a rule, it is caused immediately by a complex of several factors. Therefore, there are several medical theories about why it occurs:

The severity of the disease also varies in the number of curved arcs (from one to three) and in severity (from the first to the fourth stages):

• the first - from 1 to 10 degrees;
• the second - from 11 to 25 degrees;
• the third - from 26 to 40 degrees;
• the fourth - more than 40 degrees.

Symptoms of cervical scoliosis

The symptomatology of curvature is divided into general and specific (characteristic only for this pathology).

In the first two stages of the disease, there are still no particularly striking manifestations. However, on the third and fourth, the severity of spinal deformity can already be seen with the naked eye. It is characterized by asymmetry in the position of the head, it can be tilted forward or to one of the sides, right or left, sometimes you can see that the patient's ears are at different heights relative to each other. The violation of the symmetry of the contour of the shoulders is also very noticeable, at the last stage, changes in the symmetry of the pelvis are already visible. In some cases, in the absence of treatment, abnormal development of the bones of the skull becomes visible. All these symptoms are a reason to immediately consult a doctor and start treatment.

Most patients, as a rule, complain of difficulty in movement, pain when turning or tilting the head. Some patients come to the doctor complaining solely of the aesthetic effects of the curvature, especially in the early stages of the disease.

Common symptoms include headaches, fatigue and general weakness. The patient may also experience dizziness, especially when trying to tilt their head sharply. All this occurs due to squeezing of blood vessels and, as a result, circulatory disorders, including in the brain.

Often, with the first or second degree of cervical curvature, a person does not pay attention to problems. As a rule, all symptoms are attributed to fatigue or overexertion. But if a person complains of both a headache and neck pain at the same time, then this is a clear sign of the onset of serious problems.

In some countries, the first stage of scoliosis is not considered a disease at all and does not require any intervention from doctors. However, despite this, you should be aware of it and take measures to maintain this department in a healthy state. After all, the very fact of a small anomaly already speaks of an increased risk and the possibility of deterioration.

Diagnosis of the disease

The doctor can accurately determine the degree of scoliosis and its type based on both a visual examination and after examining the x-rays of the patient. You should not engage in self-diagnosis: determining the curvature of the spine is the field of activity of only orthopedic doctors, and self-intervention can result in a deterioration in the condition, or even serious consequences for the patient.

The main method of visual diagnosis is as follows: the patient is asked to lean forward and lower his hands. In this position, the doctor will clearly see the deformation of the spine and the displacement of individual vertebrae relative to each other.

But the main method for diagnosing curvature in the spine, especially in its cervical region, is an x-ray examination. The picture allows you to accurately determine the angle of curvature, its degree, and sometimes find out the cause of the deformation. This is done by calculating the Cobb angle. To measure it, it is necessary to draw two straight lines parallel to the neutral vertebrae on an X-ray image of the anterior-posterior projection and where they intersect, and this angle is measured. According to these data, one can judge the severity of problems with the back and neck.

If these methods are not enough, the doctor may additionally prescribe an MRI of the spine.

Treatment

Treatment is very dependent on factors such as the severity of the disease, its form, the rate of progression and, of course, the patient's health at the time of treatment. Therefore, when a doctor makes such a diagnosis, it is better not to postpone the beginning of solving the problem on the back burner, but to get down to business even before the pathology reaches some serious stage and complicates the treatment.

Popular among the people are the so-called folk remedies, breathing exercises, massage according to some special methods and psychotherapeutic practices according to the author's methods, but their effectiveness has not yet been confirmed by research.

Of the methods of treatment confirmed by practice, two are distinguished: conservative and operative.

Conservative

This method of treatment is carried out by the patient at home, but under the supervision of a doctor. Basically, it is to comply correct posture and performing a set of specific exercises that allow you to increase muscle support for the neck and align the cervical part. Conservative therapy includes such recreational activities:

• physiotherapy;
• classes in the pool;
• proper organization of the workplace and sleep on a hard bed;
• massage: therapeutic and manual;
• electrical muscle stimulation;
• wearing a corset.

Outside of sleep, you need to carefully observe your posture in ordinary life, avoid positions in which pressure is exerted on the cervical vertebrae, keep your head straight. The child should be seated in a chair that matches the height of the table.

The next item is physical therapy. The patient needs to study a set of special exercises for cervical scoliosis and perform them regularly. It will be very useful to combine physical education with swimming lessons.

Your doctor may also prescribe firming therapeutic massages and electrical stimulation. This will help improve spinal support by activating the muscles.

Particular attention should be paid to nutrition. If scoliosis is provoked by softening of the bones due to a lack of minerals and trace elements, then an increase in the diet of foods with a high content of calcium and phosphorus will significantly slow down its development.

The last thing worth noting is the use of special orthopedic corsets for the upper back and other supporting devices (including for the neck in case of a serious stage of deformity). They allow a person to straighten the cervical region, ensure that the neck is fixed in the correct position and get a slight massage effect.

But you need to know that support devices lead to weakening of the muscles and their reduction. motor activity, which is very bad for scoliotic neck disease. It is important to know that corsets and supporting devices cannot be used without the advice of an orthopedist, this is a rather radical means of correction. To a greater extent, this applies to rigid structures, which, in addition to doctor's prescriptions, also require compliance with the wearing regimen (no more than a few hours a day), since intervertebral hernias can become the consequences of abuse.

Operative or surgical method

It is involved in treatment only if conservative therapy has not yielded significant results. Most often, indications for surgical treatment appear already at the last, fourth stage of scoliosis.

Any surgical intervention requires careful monitoring of the patient's condition and a careful choice of methods by which the condition of the spine will be improved.

Surgical treatment has several options. Their choice depends on the type of pathology that needs to be eliminated:

• limiting the asymmetry of the growth of the vertebrae (this is a resection from the convex side of a part of the intervertebral disc, which makes it difficult to progress the curvature);
• stabilization of spinal deformity (fusion or fusion of several adjacent vertebrae in order to immobilize them, the use of a bone graft, which allows you to stop the movement of the vertebrae and prevent the pathology from worsening);
• curvature correction - carried out using a rigid frame, installed directly on the deformed area;
• cosmetic operations - do not eliminate the disease, but relieve some of its defects.

At surgical methods treatment has a lot of negative effects. In particular, in particularly difficult cases, complete immobility of the vertebrae may occur, and as the most deplorable result, the threat of their complete fusion can be distinguished. Unfortunately, with fusion, the patient becomes disabled and this can no longer be corrected.

Therefore, surgery is carried out with caution and only on the condition that no other methods stop the deterioration of the condition. If the patient has not yet used all the chances to correct his position without resorting to them, then the doctor should make every effort to eliminate the problem in a conservative way.

Prevention

Prevention of cervical scoliosis should begin in early childhood. Physical therapy, body position control, load distribution, a course of specialized massage - all this will help smooth out the negative effects of curvature, even if the child has a predisposition to it. A sedentary lifestyle should be dealt with especially seriously, because it can lead to weakening of the muscles and the development of the disease.

Consequences of scoliosis

Scoliosis is a disease, the consequences of which are significantly extended over time. This means that the complications themselves can manifest themselves at any time. This should be taken into account and do not postpone a visit to the orthopedist.

The most common complications of curvature:

1. Problems with the musculoskeletal system, constrained movements and muscle pain.
2. Circulatory disorders. Incorrect location of the spine in space can adversely affect the work of blood vessels.
3. Headache. It is the most common symptom and complication of cervical scoliosis, which reduces the patient's quality of life.

Of course, it is best not to bring to the manifestation of the consequences of the curvature and in time to contact specialists for treatment.

Cervical scoliosis is a very common disease of our time. Sedentary life, sleeping on too soft surfaces, lack of positive stress on the back muscles - this only contributes to the appearance of diseases and disorders in the spine, and in its cervical part, in particular. Cervical scoliosis can not only look ugly, but also cause a lot of unpleasant problems for a person: headaches, dizziness, and sometimes hypoxia (lack of oxygen) in the brain. This is an exceptionally weighty argument in favor of preventing its development. Because treatment will cost more and take much longer than prevention.

NECK DEFORMATIONS Congenital muscular torticollis Torticollis is a deformity of the neck of congenital or acquired origin, characterized by an incorrect position of the head - tilting to the side and turning it. Torticollis occurs most often due to pathological changes in the soft tissues, mainly in the sternocleidomastoid muscle (m. sterno-cleido-mastoidcus), less often as a result of anomalies in the development of the cervical spine. Based on the pathogenesis of suffering, there are impogenic, os-sebaceous, neurogenic, dermo-desmogenic and compensatory forms. Congenital muscular torticollis, according to most researchers, in relation to other congenital diseases of the musculoskeletal system ranges from 5 to 12% (S. T. Zatsepin), ranking third in frequency after congenital clubfoot and congenital hip dislocation. According to a number of authors (S. T. Zatsepin, M. O. Frpdlyand), this deformity occurs mainly in girls and is more often right-sided. Congenital muscular torticollis can also be bilateral. Among the symptoms of this disease, it should be noted the restriction of the inclination of the head in the opposite direction due to the shortening of the sternocleidomastoid muscle. Ethnology and pathogenesis. The cause and development of suffering remain not fully elucidated at the present time. All existing theories cannot fully explain the diversity of the clinical picture and the essence of the pathological process. For many years, the prevailing opinion was that muscular torticollis arises from an incorrect position of the fetus. Only in 1838, Strokmayer first suggested that muscular torticollis occurs as a result of damage to the sternocleidomastoid muscle at the time of childbirth, and the resulting hematoma and its subsequent scarring lead to a shortening of this muscle. Traumatic origin theory muscular torticollis found many supporters. So, according to S. A. Novotelyyuv, birth trauma leads not only to a shortening of the sternocleidomastoid muscle, but also to a reflex violation of its trophism, resulting in wrinkling of the muscle. However, further observations by a number of researchers did not confirm the traumatic theory of the occurrence of muscular torticollis, it was not possible to obtain blood during puncture of the altered part of the sternocleidomastoid muscle and during its histological examination. AV Protasevich (1934) cut this muscle in 2-week-old rabbits, but its growth was not disturbed in the future. Peterson believed that as a result of the incorrect position of the fetus in the uterine cavity, a persistent shortening of the sternocleidomastoid muscle occurs, which complicates childbirth and often leads to damage to this muscle. In 1895, Mikulich first put forward the inflammatory theory of muscular torticollis. The author believed that as a result of penetration of microbes into the sternocleidomastoid muscle of the fetus, chronic interstitial myositis occurs, leading to the development of this deformity. In 1902, Felker suggested that muscular torticollis is a consequence of ischemia. Ischemic contracture of the sternocleidomastoid muscle, from his point of view, is the result of pressure from the fetal shoulder on the upper part of the neck, which can lead to compression of this muscle in its lower part, which, according to the author, does not have its own vessels and is supplied blood from the upper half. At the same time, the pectoralis-clavicular-nipple muscle is supplied with blood from a large number of arterial branches that have numerous anastomoses; even in the altered part of this muscle, it is possible to detect unchanged vessels with preserved conductivity. In this regard, without completely rejecting the assumption of the possibility of impaired blood supply to the sternocleidomastoid muscle during childbirth, muscle ischemia cannot be considered the only cause of muscular torticollis, which is also confirmed by a number of histological studies. From our point of view, coinciding with the opinion of II. N. Aleksinsky (1896), V. M. Afanasyeva (1944) and S. T. Zatsepin (1960), it is most correct to assume that congenital muscular torticollis occurs due to a congenital malformation of the sternocleidomastoid muscle. Trauma, which is often observed during childbirth, especially with the gluteal position, only exacerbates the deformity. The severity of suffering is directly dependent on the severity of underdevelopment of muscle fibers and the degree of replacement of muscle tissue with connective tissue. Therefore, with clinically pronounced symptoms of congenital muscular torticollis, only those children are born in whom the number of underdeveloped muscle fibers is significant or most of muscles are replaced by fibrous connective tissue. This is confirmed by the observations of Kostendik, who in 2.6% of newborns noted clinical underdevelopment of the sternocleidomastoid muscle in the absence of pronounced symptoms of torticollis. Clinic. The picture of congenital muscular torticollis is extremely diverse and mainly depends on the age of the child. As a rule, in the first 7-10 days of a patient's life, underdevelopment of the sternocleidomastoid muscle can be detected only in some of them. So, S. T. Zatsepin found congenital muscular torticollis in only 29 out of 649 examined newborns. - its middle part, thickens and shortens, as a result of which a swelling of a dense consistency appears on the corresponding half of the neck, not soldered to the subject soft tissues . When a dense band appears, a tilt of the head occurs, later - asymmetry in the size and location of the auricles. With age, in most children, the seal in the region of the sternocleidomastoid muscle is significantly reduced or completely disappears. In a smaller part of the cases, the compaction and thickening of this muscle gradually increase, it becomes less elastic, extensible and shortens. The inclination of the head and its rotation increase, its mobility is limited, the asymmetry of the face becomes more noticeable, and the asymmetry of the skull appears. The most pronounced deformation in congenital muscular torticollis at 3-6 years of age. Its severity is mainly due to the lag in the growth of the sternocleidomastoid muscle with the correct growth of the cervical spine. A clinical examination of a sick child from the front reveals a sharp asymmetry of the face and skull. The head is tilted forward and towards the modified sternocleidomastoid muscle, but turned in the opposite direction. A higher standing of the shoulder girdle and scapula on the side of the thrust is noted. When examining the patient from behind, asymmetry of the neck, tilt, turn of the head, and higher standing of the scapula are noticeable. In most patients, both legs of the sternocleidomastoid muscle are altered, and only in some of them is one. The affected sternocleidomastoid muscle is usually thinner than normal, has the form of a strand, dense to the touch. As a rule, the trapezius and serratus anterior muscles are shortened on the side of the lesion, which leads to an asymmetric standing of the shoulder girdle and scapula. The tension of the affected sternocleidomastoid muscle, according to S. T. Zatsepin, is not associated with its tonic contraction, but with the traction of the opposite healthy muscle, trying to align the position of the head. The degree of shortening of the sternocleidomastoid muscle depends mainly on the size of the discrepancy in its length and the cervical spine, the degree of tilt and turn of the head is due to changes in the corresponding leg of this muscle. So, with the defeat of the predominantly thoracic leg, the turn of the head is more pronounced, and with gross changes in the clavicular leg, its inclination. The tension of the sternocleidomastoid muscle and the inclination of the neck lead to changes in the cervical and thoracic spine. Lorenz divides them into two types. With a mildly pronounced deformity, a simple kyphosis is observed in the cervical region, with a bulge facing in the direction opposite to the deformity. In a more severe form of suffering and in older children, as a rule, an S-shaped scoliosis of the cervical, thoracic and lumbar spine is found. The traction of the sternocleidomastoid muscle affects the shape of the mandible and the mastoid process, which is enlarged in patients with congenital muscular torticollis, and the cells of the air cavity are larger. As a rule, the direction of the ear canal changes. Half of the head on the modified side becomes more flattened and wider. The eyes and eyebrows on the side of the lesion are lower than on the healthy side. There is an abnormal development of the upper and lower jaws, as well as the accessory cavities of the nose, the nasal septum, and the hard palate. Concomitant symptoms in congenital muscular torticollis is the limitation of visual fields. Radiography with congenital muscular torticollis, except for the symmetry of the skull, does not reveal other changes. Extremely rarely there is a shortening of both sternocleidomastoid muscles. At the same time, the child’s head is tilted either backward so that the back of the head approaches the back, and the face looks up or forward. This deformity occurs when the length of the sternocleidomastoid muscles does not match the length of the cervical spine so much that the patient is unable to tilt his head either forward or backward. As a rule, in such patients, the volume of head movement is sharply limited, mainly in the sagittal plane, the cervical spine is significantly shortened. Differential d and agnostics. Recognition of congenital muscular torticollis in the first year of a child's life does not present significant difficulties, . since acquired forms of deformation are extremely rare in them. In older children, congenital muscular torticollis must be differentiated from the Klippel-Feil syndrome, cervical ribs, wedge-shaped hemivertebrae of the neck, pterygoid neck, as well as with acquired forms of torticollis - Grisel's disease (see below), spastic, dermatogenous and desmagnetized forms of torticollis. Spasmodic torticollis is one of the types of hyperkinesis and is characterized by movements that do not obey the will of the patient, or a forced position of the head due to the alternation of clopic and tonic spasms of the cervical muscles. Suffering arises after suffering encephalitis, develops gradually and progresses relentlessly over time. Dermatology and other forms of torticollis are due to the presence of extensive scars in the neck after a burn, lupus. Desmogenic forms of torticollis are the result of cervical lymphadenitis or phlegmon. Torticollis due to chronic inflammatory processes in the sternocleidomastoid muscle: is the result of myositis, typhus, malaria, scarlet fever, gummous syphilis. An inclined position of the head is possible as a result of an injury or a pathological process in the bodies of the cervical vertebrae - osteomyelitis, tuberculosis, actinomycosis, neoplasms. Treatment. Conservative treatment of muscular torticollis should begin at 2 weeks of age. Basically, it consists in corrective gymnastic exercises, carried out 3-4 times a day for 5-10 minutes. At the same time, the head of the child lying on his back is clasped with both hands and given it as correct a position as possible, that is, tilted in the direction opposite to the affected muscle and turned to a healthy one. The described manipulation is so simple that it can be successfully performed by the mother. Therapeutic exercises should be carried out without violence, since as a result of excessive stretching of the sternocleidomastoid muscle, even deeper changes can occur. At the same time, a massage of a healthy sternocleidomastoid muscle and kneading of the victim are prescribed, as well as a course of physiotherapy procedures (UHF). In children aged 6-8 weeks, in order to prevent scarring of the affected muscle, a course of ion-galvanization with potassium iodide, consisting of 30 sessions, can be carried out, the course of treatment can be repeated after 3-4 months. Great importance during this period should be given to massage the entire half of the face and neck on the affected side. To keep the child's head in the achieved position of hypercorrection, it is recommended to wear a Shants cardboard-cotton collar or a bonnet that is attached with ribbons "from the sore side to the cloth bra. You can put the child in a specially made plaster bed or fix the head in the correct position between the pouch - mi with sand.The crib of the newborn in the room should be installed in such a way that the healthy half of the neck is facing the wall. Following what is happening in the room and turning his head towards the changed muscle, the child will involuntarily give it the correct position. With an unsharply pronounced form of muscular torticollis, timely conservative treatment leads to a complete cure of the child in the first year of his life. With a more severe degree of deformity, conservative treatment should be continued until the age of 3, when the symptoms of an increase in volume and compaction of the sternocleidomastoid muscle completely disappear. In some patients with significant underdevelopment of the sternocleidomastoid muscle, deformity can be eliminated only by surgery. Surgical treatment of congenital muscular torticollis in order to eliminate the main symptoms of deformity is indicated for children aged 3–4 years or those older patients in whom conservative treatment has not led to stabilization of the pathological process. The indication for surgery is the growing asymmetry of the face and skull, the development of which, unlike the symptoms of mouse tension and head tilt, cannot be prevented by conservative methods.