baby scoliosis
Introduction
Introduction Infantile idiopathic scoliosis is a structural spinal deformity found within 3 years of age. This type is relatively common in Europe, and in the United States, this type is less than 1% in patients with idiopathic scoliosis. Early diagnosis of infantile idiopathic scoliosis is important, and parents and pediatricians should closely observe this. Because early treatment can affect the prognosis, it should be treated as soon as possible.
Cause
Cause
The cause of infant scoliosis:
(1) Causes of the disease:
Because idiopathic scoliosis accounts for the vast majority of scoliosis, if it can understand its cause, it is of great significance for prevention and treatment. Therefore, people have been devoted to the exploration of the cause of idiopathic scoliosis for many years, but so far The exact cause has not yet been found.
In 1979, Herman demonstrated that patients with idiopathic scoliosis had labyrinthic impairment. In 1984, Yamada also performed a balanced function test on patients with idiopathic scoliosis. Results showed that 79% showed significant balance dysfunction, while the control group had only 5 %, Wyatt also found that patients with scoliosis had significant vibration imbalance, and there was a central disorder in the posterior column pathway of patients with scoliosis, but these studies did not clarify the relationship between idiopathic scoliosis and balance disorder, but did not explain idiopathic The cause of scoliosis itself.
It was observed that the height of patients with idiopathic scoliosis was higher than that of normal peers. The authors also had the results of the 1984 census, which prompted people to understand the relationship between growth hormone and idiopathic scoliosis. First, the growth hormone content is still a matter of debate. More literature discusses the relationship between paravertebral muscles and idiopathic scoliosis. The detection of paraspinal muscles includes: muscle spindle, muscle fiber morphology, muscle biochemistry, and myoelectricity. The content of calcium, copper, zinc, etc., although abnormal findings, did not directly clarify the cause of the disease, people also from the familial investigation, the investigation of the genetic problems of patients with hyperthyroidism, but more patients can not use a single Genetic abnormalities are explained, so the cause of idiopathic scoliosis is still an important topic that people will explore in the future.
(2) Pathogenesis:
The pathological changes of idiopathic scoliosis mainly include the following:
1. The vertebral body, spinous process, lamina and facet joints change the convex and concave side of the vertebral body, and rotate, the main vertebral body and spinous process rotate to the concave side, and the concave side pedicle becomes shorter and becomes shorter. Narrow, the lamina is slightly smaller than the convex side, and the spinous process is inclined to the concave side, so that the concave side spinal canal is narrowed. On the concave side, the small joint is thickened and hardened to form an epiphysis.
2. Changes in the ribs The rotation of the vertebral body causes the convex side ribs to move to the back side, causing the back back to protrude, forming a hump. In severe cases, it is called "razor-back", and the convex side ribs are separated from each other, and the gap is increased. The wide, concave side ribs are squeezed together and protrude forward, resulting in asymmetrical chest.
3. Intervertebral disc, muscle and ligament changes The concave side intervertebral space is narrowed, the convex side is widened, and the small muscle on the concave side is slightly contracted.
4. Changes in viscera Severe thoracic deformity causes deformation of the lungs. Due to alveolar atrophy, lung expansion is limited, excessive tension in the lungs causes obstruction of the circulatory system, and severe cases can cause pulmonary heart disease.
Examine
an examination
Related inspection
Spinal examination of the spine MRI
Examination of the diagnosis of infant scoliosis:
In 1954, James first recognized infantile scoliosis as a unique whole, and found that there are two cases of natural disease, and divided into two types according to this: self-limiting and progressive. A large number of studies have confirmed that the characteristics of infantile idiopathic scoliosis are as follows:
(1) The average male baby is more common, usually the side bends to the left.
(2) The lateral curvature is generally located in the thoracic segment and the thoracolumbar segment.
(3) Most scoliosis progresses within 6 months after birth.
(4) Self-limited infantile idiopathic scoliosis accounts for 85% of all infantile idiopathic scoliosis.
(5) Double chest flexion is easy to progress and develops into severe deformity. Female patients with right thoracic curve usually have a poor prognosis and are often accompanied by malformations (flat head deformity, bat ear deformity, congenital torticollis, and progressive hip development). Poor health search, etc.).
Scoliosis not only causes deformity, collapse, pain and other symptoms of the trunk, which reduces its labor ability, can not participate in normal work, and causes great harm to the mental health of children, and can lead to disability, and the quality of life of patients decreases. It also causes some social problems, such as 76% of female patients are unmarried, and early or severe scoliosis can lead to lung dysplasia, atelectasis, cardiopulmonary insufficiency and paraplegia, making patients' life expectancy lower than normal, according to statistics The average life expectancy is 46.4 years old.
Diagnosis
Differential diagnosis
Symptom identification of infant scoliosis:
Spinal curvature: Spinal curvature means that one or more segments of the spine are bent laterally from the midline of the body in the coronal plane to form a curvature of the spine, usually accompanied by rotation of the spine and posterior process on the sagittal plane. Or the increase or decrease of the protrusion, as well as the ribs of the ribs, the rotation of the pelvis, and the ligaments and muscles of the paravertebral. It is a symptom or X-ray sign that can be caused by many diseases.
Bamboo spine: An obvious symptom of ankylosing spondylitis is the bamboo spine. Ankylosing sporidylitis (AS) is a chronic progressive inflammatory disease that primarily invades the spine and can affect the ankle and surrounding joints to varying degrees. The disease is also known as Marie-strümpell disease, Von Bechterew disease, rheumatoid spondylitis, deformity spondylitis, rheumatoid center type, etc., now known as AS. AS is characterized by inflammation and ossification of the lumbar, cervical, and thoracic spine joints and ligaments, and the ankle joint. The hip joint is often involved, and inflammation can occur in other surrounding joints. The disease is generally negative for rheumatoid factor, so it is associated with Reiter syndrome, psoriatic arthritis, enteropathic arthritis and other seronegative spondylosis.
Pre-spinal mutations were localized to local analgesia: positive leg elevation test, limited lumbar motion, direct pre-spinal mutation, localized pain, erector spinae. These symptoms are due to mononeuropathy and plexus neuropathy. Peripheral spinal neuropathy refers to the structural and dysfunction of spinal cord and brainstem motor neurons, primary sensory neurons, axons of surrounding autonomic neurons, and/or Schwann cells and myelin.
Scoliosis: Scoliosis is when one or more segments of the spine are bent laterally from the midline of the body in the coronal plane to form a curvature of the spine, usually accompanied by the rotation and sagittal plane of the spine. Increase or decrease of kyphosis or protrusion, as well as rib unequal height, pelvic rotation tilt deformity and paravertebral ligament and muscle abnormality, it is a symptom or X-ray sign, which can be caused by various diseases . In 1954, James first recognized infantile scoliosis as a unique whole, and found that there are two cases of natural disease, and divided into two types according to this: self-limiting and progressive. A large number of studies have confirmed that the characteristics of infantile idiopathic scoliosis are as follows:
(1) The average male baby is more common, usually the side bends to the left.
(2) The lateral curvature is generally located in the thoracic segment and the thoracolumbar segment.
(3) Most scoliosis progresses within 6 months after birth.
(4) Self-limited infantile idiopathic scoliosis accounts for 85% of all infantile idiopathic scoliosis.
(5) Double chest flexion is easy to progress and develops into severe deformity. Female patients with right thoracic curve usually have a poor prognosis and are often accompanied by malformations (flat head deformity, bat ear deformity, congenital torticollis, and progressive hip development). Poor health search, etc.).
Scoliosis not only causes deformity, collapse, pain and other symptoms of the trunk, which reduces its labor ability, can not participate in normal work, and causes great harm to the mental health of children, and can lead to disability, and the quality of life of patients decreases. It also causes some social problems, such as 76% of female patients are unmarried, and early or severe scoliosis can lead to lung dysplasia, atelectasis, cardiopulmonary insufficiency and paraplegia, making patients' life expectancy lower than normal, according to statistics The average life expectancy is 46.4 years old.
