What to Know about Dextroscoliosis?

Dextroscoliosis is a variety of scoliosis distinguished by abnormal spine curvature. Most often, this disease is referred to as idiopathic scoliosis. The word idiopathic has Greek roots and means “pathology in itself.” In simple terms, idiopathic means a condition not associated with any other disease or disorder. Unfortunately, the term idiopathic is widely used in the medical literature to refer to a disease for which the cause is unknown.

There are three main types of idiopathic scoliosis, which are divided according to the age of onset:

• Infantile scoliosis is a curvature that begins to develop before two. In 9 out of 10 cases, this type of scoliosis disappears spontaneously. This sort of scoliosis is very rare.
• Juvenile idiopathic scoliosis curvature of the spine that develops between the ages of two and ten. This type is also quite rare.
• Adolescent idiopathic scoliosis – this type appears in early adolescence and is much more common in girls than boys. While mild curvature is equally common in girls and boys, the curvature requiring treatment is eight times more common in adolescent girls than in boys.

In this article, we will talk about the common manifestations of scoliosis in order to show the main differences between the main topic of idiopathic scoliosis, which differs from the typical disease.

Factors Influencing the Progress of Idiopathic Scoliosis

The following aspects most often influence the development of idiopathic scoliosis:

• Hereditary predisposition. This includes the tension on the spinal cord caused by a thickened/tight filum terminal, which can trigger a spinal curvature mechanism (idiopathic scoliosis). The disease that causes this symptom is genetic and can be inherited.
• Age. Idiopathic scoliosis often begins to show during periods of intense growth during adolescence. It can also manifest itself at an earlier age or in adults. In the first period of life, the tension of the spinal cord can gradually increase, provoking a curvature of the spine.
• Gender. Most current research agrees that although all children can suffer from scoliosis, girls are more likely to be at risk of worsening during development.
• The degree of curvature. With scoliosis more than 40 degrees, regardless of the patient’s age, the curvature of the spine is influenced. Therefore, when the curvature exceeds 40-50 degrees, the development of scoliosis can continue up to the most severe form and reach more than 70-90 degrees.
• A sudden increase in spinal cord tension. It was noticed that the tensile force might increase after a fall or spinal injury in patients with pre-existing filum termini disease. In these cases, there is an increase in the curvature of the spine. Thus, the cause of scoliosis is not trauma but the development of a pre-existing curvature.

Risk of progression of idiopathic scoliosis

The Mechanism of Development of Scoliosis

The process of spine curvature formation begins with the fact that the inner part of the intervertebral disc is displaced to the side. This entails displacement of the vertebrae and their deformation. As a result, an intermediate state is formed, which over time, due to insufficient muscle strength, turns into scoliosis. The most dangerous periods for the development and progression of scoliosis are the stages of intensive growth: from 4-6 years to 10-14 years. In this case, one should be especially attentive to the child’s health at the stage of puberty, which occurs in boys at 11-14 years old, and in girls at 10-13 years old.

Dextroscoliosis should not be confused with common poor posture. Poor posture can be corrected through normal exercise, table seating training, and similar activities and have certain reasons. On the other hand, idiopathic scoliosis requires a special complex systematic treatment throughout the entire period of the patient’s growth and has an unknown reason. The risk of aggravating scoliotic deformity increases in cases when, by the beginning of these periods, the child already has a radiologically confirmed first degree of scoliosis (up to 10 degrees).

Complications of Idiopathic Scoliosis

Most complications of idiopathic scoliosis include:

• Chronic pain. With scoliosis, spinal pain, headaches, gait problems, and blockages in the back or limbs can become chronic and more intense.
• Appearance. With the development of scoliosis more than 20-30 degrees, as a result of the body’s adaptation to the curvature of the spine, may appear changes in the body and posture that affect the patient’s appearance and posture (for example, an asymmetry between the two halves of the body).  Such changes, especially in adolescence, can affect the psychosocial well-being of the patient in addition to the functional state.
• Chest damage. The chest can press on the lungs and heart in severe scoliosis, making breathing and heart functions difficult.

Depending on the degree of curvature of the spine, scoliosis can, over time, cause additional harm to the body, for example, difficulties and dysfunctions that will increasingly affect an individual’s life. Therefore, you should not waste time and consult your doctor.

Symptoms of Dextroscoliosis

In the initial stages, dextroscoliosis is almost asymptomatic, so you should pay attention to the following signs:

• One shoulder is higher than the other.
• When a person stands with their arms at their sides, the distance between the arm and the waist is different on both sides.
• The shoulder blades are located asymmetrically – the shoulder blade is closer to the spine on the concave side, its angle protrudes.
• When tilting, the curvature of the spine becomes noticeable.

If the listed symptoms of scoliosis are detected, you should contact an orthopedist to conduct a detailed examination and prescribe appropriate treatment when confirming the diagnosis. Early diagnosis of dextroscoliosis is of particular importance for the effectiveness of subsequent treatment, compensation for impairments, and the child’s normal development.

The following symptoms also characterize scoliosis:

• Decreased range of motion or back stiffness
• Back pain
• Stiffness and pain after prolonged sitting or standing
• Pain when lifting weights
• Radiation of pain to areas away from the spine (often in the buttocks and legs)
• Muscle spasm
• Difficulty walking
• Labored breathing

Diagnosis of Idiopathic Scoliosis

Diagnosis of idiopathic scoliosis includes procedures such as:

• measuring the length of the lower limbs, kyphosis
• determining the mobility of the ankle, knee, and hip joints
• evaluating the mobility of the lumbar spine and the symmetry of the waist triangles
• defining the position of the shoulder girdles and shoulder blades
• an examination of the chest, abdomen, pelvis and lower back is performed
• assessing muscle tone, muscle rollers, rib deformation, etc.

In the flexion position, the presence or absence of asymmetry of the spine is determined. In the sitting position, the length of the spine is measured, and the degree of lumbar lordosis is determined, lateral curvature of the spine and deviations of the trunk are detected. The position of the pelvis is assessed regardless of the position of the lower extremities. In the supine position, the change in the curvature of the spine’s arch is assessed, and the muscles of the abdomen and internal organs are examined.

Dextroscoliosis Treatment

The choice of treatment for a patient with juvenile idiopathic scoliosis depends on the magnitude of the deformity, the patient’s age, and the degree of maturity of the skeleton (growth potential) and usually includes:

• Control. If the deformation is insignificant (15-20 °), the patient needs dynamic observation by the orthopedist at the residence. To this end, in addition to an examination, the doctor should prescribe X-ray control every six months during rapid growth and then once a year. If the deformation progresses, it is required to take measures to stop its development immediately.
• Physiotherapy exercises. One of the key points in the conservative treatment of dextroscoliosis in children and adolescents is physical therapy. Patients with idiopathic scoliosis should continue active physical activity and participate in sports competitions. The most favorable sport is swimming. Outdoor games and hardening will have a great effect on the condition of the muscular system. The most unfavorable are working with heavyweights in a standing position and running.
• Fixation in a corset. Fixation in a corset is usually used when the deformation is in the range of 25-40 °, especially if the patient retains the growth potential and the curvature may increase. However, orthopedists are ambivalent about the use of corsets for the treatment of spine curvature. In addition to the immobilizing effect on the spine, the corset also immobilizes the muscles, which leads to their further weakening. Therefore, it is prescribed in individual cases.

It is also used massage, electromyostimulation, and electrophoresis in the treatment of spine curvature to achieve a therapeutic effect. As for surgical treatment, it should be considered the only justified method in patients with idiopathic scoliosis in the following cases:

• if the deformation is more than 40-45 °;

• with pulmonary heart failure caused by scoliotic deformity;

• with neurological complications of scoliosis;

• with pain;

• with a steady progression of the deformity.

After the onset of skeletal maturity, deformities are less than 40 °, do not tend to progress, and therefore do not require surgical corrections. Deformities greater than 100 ° are rare and can cause a threat to life due to the development of formidable complications from the heart, lungs, and spinal cord. The main task of surgical treatment is an instrumental correction in combination with fusion (formation of a total bone block). Despite the high prevalence of the disease, only a small percentage of patients require surgical treatment. Most people with scoliosis have the first degree, which often does not progress.

General Exercise Therapy Exercises

Patient-specific exercise has been shown to be effective in the initial treatment of spine curvature. They can include:

• Exercises for mobility/flexibility of the spine.
• Exercises to strengthen the muscles of the trunk.
• Stretching hamstrings and other tense muscles of the lower limbs.
• Correction of the walking pattern.
• Difficult functional exercises such as squats or lunges.
• Cardio and fitness tips.
• Pilates/yoga.
• An individualized rehabilitation program, for example, exercises aimed at optimizing the functions in the sports that the patient is involved in.

Schroth Method

The Schroth Method is a set of exercises specifically designed for patients with spine curvature, especially those with idiopathic scoliosis. It was developed by Katharina Schroth in Germany. The Schroth method is focused on preventing the progression of the curvature until the end of growth.

• Active correction of the spine to avoid surgery.
• Postural training to avoid or slow the progression of the curvature.
• Communication to support the decision-making process.
• Home exercise program.
• Support network.
• Pain prevention and management strategies.

Prevention of Dextroscoliosis

• A patient with a curvature of the spine needs a special bed with a hard mattress. It is necessary to ensure that the patient sleeps more often on his back.
• A child with a curvature needs to organize his workplace correctly. The table and chair should be selected based on the height of the child, not his age since furniture manufacturers sometimes do not take into account the acceleration processes.
• Much attention should be paid to the nutrition of a child with scoliosis. The diet should contain at least one hundred grams of protein per day, and food should include calcium, magnesium, and sodium.

In conclusion, it should be said that scoliosis, especially in childhood and adolescence, is easier to prevent than cure. One of the main methods of preventing curvature of the spine is physical education, sports, and a healthy lifestyle. Also, do not forget to visit qualified specialists more often.

FAQ

• What is infantile idiopathic scoliosis?

Infantile scoliosis is a deformity of the spine that develops in the first four years of life. The word idiopathic means that the cause of this scoliosis cannot be found out.

• In what position to sleep with dextroscoliosis?

With dextroscoliosis, it isn’t easy to find a comfortable position and sleep all night soundly. The most favorite position is usually used – on the side, with one leg drawn in and the other extended. Sleeping on the back is allowed, but on the stomach is prohibited – in this position, the vertebrae are pinched, and the nerves are pinched.

• What can’t you do if you have idiopathic scoliosis?

With scoliosis, you should:

1. not “freeze” in one position – neither sitting nor standing
2. not carry heavy in one hand
3. avoid falls, injuries
4. not overload the ridge
5. office workers need to take a warm-up break
6. not make sharp circular movements

• What can you do if you have scoliosis?

With scoliosis, the following are allowed:

1. hiking
2. race walking
3. walking with sticks
4. backstroke
5. amateur dancing
6. yoga
7. pilates