- Lumbar spine(with apical vertebrae L2 and lower lumbar limiting);
- Dorsal-lumbar spine(central and lower back, with apical vertebrae D12-L1 and limiting lower lumbar);
- Dorsal (with lower limiting vertebrae at the level of D12 or higher);
- Cervico-dorsal (with apical level D2 or higher).
We must distinguish unstructured scoliosis or the scoliotic attitude (without hump or rotation, with lateral deviation that is completely reduced in supine decubitus) from real ( structured ) scoliosis. The latter presents a lateral curve with rotation, hump, discs and deformed vertebrae. Scoliosis also leads to anatomical deformations involving ribs and ligaments.
According to the extent, we can distinguish between:
- Mild scoliosis of lumbar spine (<30 degrees).
- Moderate scoliosis of lumbar spine (30 ° -50 degrees).
- Severe scoliosis of lumbar spine (> 50 degrees).
Complications of mild scoliosis of lumbar spine
Symptoms vary from person to person and according to the time of the deformity:
Symptoms that may appear in the long term:
- Shoulders with different heights (asymmetrical).
- One shoulder blade more prominent than the other.
- Back pain of a muscular nature.
Symptoms may appear in the short term:
- Body inclined towards one side.
- Prominent and raised hip.
- Asymmetrical waist (one side seems higher than the other).
- Uneven hips.
- Unbalanced pelvis.
- Ribs prominent or of different heights, clearly visible when the subject leans forward.
It is essential to diagnose scoliosis early to prevent aggravation of the deformity leading to serious complications.
Causes of mild scoliosis of lumbar spine
In 65% of cases, scoliosis is idiopathic , meaning it occurs without known causes. For 15% of cases, it is congenital, meaning the malformations of the spine are present from birth.
Other causes can be:
- Genetic diseases.
- Problems in development (such as incomplete formation of the vertebrae).
- Neuromuscular pathologies (such as poliomyelitis).
- Uneven length of the limbs.
- Muscular dystrophy or atrophy.
- Muscle paralysis of one side of the back.
- Spina bifida.
- Marfan syndrome.
- Prader-Willi syndrome.
- Tumors (multiple endocrine neoplasia type 2B).
Generally, mild scoliosis of lumbar spine occurs during puberty, when growth rates are faster.
To hope for successful conservative treatment, it is important to know how to spot scoliosis with an early diagnosis .
The diagnostic process includes:
- Clinical evaluation with the Adams test.
- Full length x- ray of the spine when standing.
- MRI to evaluate the state of the spinal cord.
- Through the examination of the radiography it will be possible to evaluate the curvature with the measurement of the Cobb angle .
Mild scoliosis of lumbar spine: which therapies?
To plan a personalized and effective therapeutic path , the Fitoont telehealth platform offers a free first consultation with global and district assessment .
We can diagnose and treat you also through our platform, which was developed specifically for such cases, while you are in your home. Postural assessment is done through specific tests. These tests are completely dedicated to diagnosing your condition online.
With reference to childhood idiopathic scoliotic diseases , we generally follow the following guidelines:
- Periodic observation with monitoring every 3-6 months by radiography, in case of scoliosis below 10 ° Cobb.
- Treatments of kinesitherapy and Global Postural Re -education for scoliosis between 10 ° and 20 ° Cobb in order to avoid surgery.
- Postural re-education and use of a brace for scoliosis between 20 ° and 40 ° Cobb with important developmental thrusts. The most suitable corset in case of back-lumbar scoliosis is the Cheneau model , a one-piece high polyethylene corset, which reaches up to D4. The axillary parts extend forward and are connected by a modular tie rod.
Above 40 ° Cobb it is necessary to resort to vertebral arthrodesis surgery to avoid cardiorespiratory complications or serious deformities.
Mild lumbar Scoliosis treated with the Mezieres method
When treating scoliosis up to 40 degrees Cobb angle, the goal is always to stabilize idiopathic spinal mild scoliosis . Being able to block the degeneration and the evolutionary process of mild spinal lumbar scoliosis represents an important success in Physiotherapy. With the Mezieres method Global Postural Rehabilitation, remarkable results can be achieved.
The exercises performed with this method aim at the three-dimensional by:
- Self-correction of the spine.
- Stabilizing the correct posture.
- Re-educating the patient in proprioception.
For the biomechanical aspect, a series of factors must be taken into consideration:
The postural attitudes in the flat back, kypholordosis, imbalance of the pelvis (more anterior than the thorax) are due to compensation of the muscle chains both at the level of distribution of load forces and at the level of balance of skeletal/ myofascial tensions.
The Mezieres method aims to act on the muscle chains, which support the spine to restore the balance of the posture of the entire spine, lower and upper limbs.
Global Postural Re-education involves the progressive lengthening of the posterior muscle chain. By assuming certain postures, thanks to the support of an expert mezierist, a harmonious lengthening of the myofascial chains is induced to normalize body alignment. As shortened muscles are stretched, weaker ones are strengthened.
Usually, with the Mezieres method excellent results are obtained in the adolescent patient both in terms of aesthetics and, above all, of functionality.
Mild scoliosis of lumbar spine in pregnancy
During pregnancy, the back supports the weight of the growing fetus, which causes the lumbar spinal curves to accentuate and requires more effort. Being pregnant and having scoliosis is not easy, although it will depend on the level of curvature of the back, for this reason, it is necessary for the doctor to closely monitor the evolution of both the mother and the baby.
Normally, during the first trimester, the expectant mother, who also has mild scoliosis of lumbar spine, will hardly notice any symptoms. Although if the deviation is pronounced it can start earlier. The symptoms you will notice during this stage will be the same as those experienced by any pregnant woman with mild lumbar scoliosis, pregnant or not:
- Pressure on the heart or lungs.
- Increased curvature of the back.
- Decreased physical capacity.
- Nervous system involvement.
- Imbalance between the arms.
- Legs and hips appearing asymmetrically
However, as the pregnancy progresses, three symptoms can be highlighted that will affect the quality of life of the pregnant woman:
1- low Back Pain: It is normal for a pregnant woman to experience lower back pain due to weight bearing, however, women who also suffer from mild lumbar scoliosis will see this problem increase, causing a higher level of pain in the lower back. As a result, they will find themselves having trouble walking or sleeping.
2- Decreased lung capacity: The increased size of the placenta causes the internal organs to move to accommodate the fetus. This will put a lot of pressure on the diaphragm, as well as, making it difficult to breathe. On the other hand, lumbar scoliosis is associated with respiratory distress which, along with the pressure exerted by the uterus on the diaphragm, will affect the increased oxygen consumption.
3- Movement limitations: During pregnancy the height difference in the legs, hips or arms increases, causing difficulties in moving properly.
Scoliosis is not an impediment to becoming pregnant, but it can only increase some of the usual symptoms of the condition. Therefore, it is important to take extreme care of the back.
Treatment of mild scoliosis of lumbar spine
Mild scoliosis is usually treated with bracing, surgery, in addition to, drug treatment to lessen scoliosis symptoms. However, during pregnancy the woman is very limited, she cannot wear a corset and drugs and surgery are only recommended in case there is no other alternative due to the risks that it can cause to the fetus.
For these reasons, to relieve symptoms, there are many alternative methods, such as:
- Prenatal belt.
- Avoid bad posture or take weight.
- Perform stretching exercises for the lower back and back.