Scoliosis Health Dictionary

A combination of SCOLIOSIS and KYPHOSIS in which the spine (see SPINAL COLUMN) is abnormally curved sideways and forwards. The condition may be the result of several diseases affecting the spinal muscles and vertebrae, or it may happen during development for no obvious reason. Although braces may reduce the deformity, an operation may be necessary to correct it.... kyphoscoliosis

The healthy chest is gently rounded all over, its contour being more rounded in women by the breast tissue. In cross-section it is oval-shaped with a longer dimension from side to side than from back to front.

Barrel chest is found in long-standing ASTHMA or chronic BRONCHITIS and EMPHYSEMA, when the lungs are chronically enlarged. The anterio-posterior dimension of the chest is increased and the ribs are near horizontal. In this position they can produce little further expansion of the chest, and breathing often relies on accessory muscles in the neck lifting up the whole thoracic cage on inspiration.

Pigeon chest is one in which the cross-section of the chest becomes triangular with the sternum forming a sort of keel in front. It may be related to breathing problems in early life.

Rickety chest is uncommon now and is caused by RICKETS in early life. There is a hollow down each side caused by the pull of muscles on the softer ribs in childhood. The line of knobs produced on each side where the ribs join their costal cartilages is known as the rickety rosary.

Pectus excavatum, or funnel chest, is quite a common abnormality where the central tendon of the diaphragm seems to be too short so that the lower part of the sternum is displaced inwards and the lower ribs are prominent. When severe, it may displace the heart further to the left side.

Local abnormalities in the shape of the chest occur when there is a deformity in the spine such as scoliosis which alters the angles of the ribs. The chest wall may be locally ?attened when the underlying lung is reduced in size locally over a prolonged period. (See SPINE AND SPINAL CORD, DISEASES AND INJURIES OF.) This may be seen over a scarred area of lung such as that observed in pulmonary TUBERCULOSIS.... chest, deformities of

Scoliosis A condition where the spine is curved to one side (the spine is normally straight when seen from behind). The deformity may be mobile and reversible, or ?xed; if ?xed it is accompanied by vertebral rotation and does not disappear with changes in posture. Fixed scoliosis is idiopathic (of unknown cause) in 65–80 per cent of cases. There are three main types: the infantile type occurs in boys under three and in 90 per cent of cases resolves spontaneously; the juvenile type affects 4–9 year olds and tends to be progressive. The most common type is adolescent idiopathic scoliosis; girls are affected in 90 per cent of cases and the incidence is 4 per cent. Treatment may be conservative with a ?xed brace, or surgical fusion may be needed if the curve is greater than 45 degrees. Scoliosis can occur as a congenital condition and in neuromuscular diseases where there is muscle imbalance, such as in FRIEDREICH’S ATAXIA.

Kyphosis is a backward curvature of the spine causing a hump back. It may be postural and reversible in obese people and tall adolescent girls who stoop, but it may also be ?xed. Scheuermann’s disease is the term applied to adolescent kyphosis. It is more common in girls. Senile kyphosis occurs in elderly people who probably have osteoporosis (bone weakening) and vertebral collapse.

Disc degeneration is a normal consequence of AGEING. The disc loses its resiliance and becomes unable to withstand pressure. Rupture (prolapse) of the disc may occur with physical stress. The disc between the fourth and ?fth lumbar vertebrae is most commonly involved. The jelly-like central nucleus pulposus is usually pushed out backwards, forcing the annulus ?brosus to put pressure on the nerves as they leave the spinal canal. (See PROLAPSED INTERVERTEBRAL DISC.)

Ankylosing spondylitis is an arthritic disorder of the spine in young adults, mostly men. It is a familial condition which starts with lumbar pain and sti?ness which progresses to involve the whole spine. The discs and ligaments are replaced by ?brous tissue, making the spine rigid. Treatment is physiotherapy and anti-in?ammatory drugs to try to keep the spine supple for as long as possible.

A National Association for Ankylosing Spondylitis has been formed which is open to those with the disease, their families, friends and doctors.

Spondylosis is a term which covers disc degeneration and joint degeneration in the back. OSTEOARTHRITIS is usually implicated. Pain is commonly felt in the neck and lumbar regions and in these areas the joints may become unstable. This may put pressure on the nerves leaving the spinal canal, and in the lumbar region, pain is generally felt in the distribution of the sciatic nerve – down the back of the leg. In the neck the pain may be felt down the arm. Treatment is physiotherapy; often a neck collar or lumbar support helps. Rarely surgery is needed to remove the pressure from the nerves.

Spondylolisthesis means that the spine is shifted forward. This is nearly always in the lower lumbar region and may be familial, or due to degeneration in the joints. Pressure may be put on the cauda equina. The usual complaint is of pain after exercise. Treatment is bed rest in a bad attack with surgery indicated only if there are worrying signs of cord compression.

Spinal stenosis is due to a narrowing of the spinal canal which means that the nerves become squashed together. This causes numbness with pins and needles (paraesthia) in the legs. COMPUTED TOMOGRAPHY and nuclear magnetic resonance imaging scans can show the amount of cord compression. If improving posture does not help, surgical decompression may be needed.

Whiplash injuries occur to the neck, usually as the result of a car accident when the head and neck are thrown backwards and then forwards rapidly. This causes pain and sti?ness in the neck; the arm and shoulder may feel numb. Often a support collar relieves the pain but recovery commonly takes between 18 months to three years.

Transection of the cord occurs usually as a result of trauma when the vertebral column protecting the spinal cord is fractured and becomes unstable. The cord may be concussed or it may have become sheared by the trauma and not recover (transected). Spinal concussion usually recovers after 12 hours. If the cord is transected the patient remains paralysed. (See PARALYSIS.)... spine and spinal cord, diseases and injuries of

An inherited disease, now called neuro?bromatosis. About one case occurs every 3,000 live births. The disease is characterised by tumours along the course of nerves which can be felt beneath the skin. Soft tumours may also develop beneath the skin. The condition may have other associated abnormalities such as SCOLIOSIS, decalci?cation of the bones due to overactivity of the PARATHYROID glands, and ?brosis in the lungs. Surgery may be needed for cosmetic reasons or to relieve pressure on the nervous system.... von recklinghausen’s disease

The process by which air passes into and out of the lungs to allow the blood to take up oxygen and dispose of carbon dioxide. Breathing is controlled by the respiratory centre in the brainstem. When air is inhaled, the diaphragm contracts and flattens. The intercostal muscles (muscles between the ribs) contract and pull the ribcage upwards and outwards. The resulting increase in chest volume causes the lungs to expand, and the reduced pressure draws air into the lungs. When air is exhaled, the chest muscles and diaphragm relax, causing the ribcage to sink and the lungs to contract, squeezing air out.

In normal, quiet breathing, only about a 10th of the air in the lungs passes out to be replaced by the same amount of fresh air (tidal volume). This new air mixes with the stale air (residual volume) already held in the lungs. The normal breathing rate for an adult at rest is 13–17 breaths per minute. (See also respiration.)breathing difficulty Laboured or distressed breathing that includes a change in the rate and depth of breathing or a feeling of breathlessness. Some degree of breathlessness is normal after exercise, particularly in unfit or overweight people. Breathlessness at rest is always abnormal and is usually due to disorders that affect the airways (see asthma), lungs (see pulmonary disease, chronic obstructive), or cardiovascular system (see heart failure). Severe anxiety can result in breathlessness, even when the lungs are normal (see hyperventilation). Damage to the breathing centre in the brainstem due to a stroke or head injury can affect breathing. This may also happen as a side effect of certain drugs. Ventilator assistance is sometimes needed.

At high altitudes, the lungs have to work harder in order to provide the body with sufficient oxygen (see mountain sickness). Breathlessness may occur in severe anaemia because abnormal or low levels of the oxygen-carrying pigment haemoglobin means that the lungs need to work harder to supply the body with oxygen. Breathing difficulty that intensifies on exertion may be caused by reduced circulation of blood through the lungs. This may be due to heart failure, pulmonary embolism, or pulmonary hypertension. Breathing difficulty due to air-flow obstruction may be caused by chronic bronchitis, asthma, an allergic reaction, or lung cancer. Breathing difficulty may also be due to inefficient transfer of oxygen from the lungs into the bloodstream. Temporary damage to lung tissue may be due to pneumonia, pneumothorax, pulmonary oedema, or pleural effusion. Permanent lung damage may be due to emphysema. Chest pain (for example, due to a broken rib) that is made worse by chest or lung movement can make normal breathing difficult and painful, as can pleurisy, which is associated with pain in the lower chest and often in the shoulder tip of the affected side.

Abnormalities of the skeletal structure of the thorax (chest), such as severe scoliosis or kyphosis, may cause difficulty in breathing by impairing normal movements of the ribcage.... breathing

Abnormal muscle rigidity, causing painful spasms, unusually fixed postures, or strange movements. Dystonia may affect a localized area of the body, or may be more generalized. The most common types of localized dystonia are torticollis (painful neck spasm) and scoliosis (abnormal sideways curvature of the spine). Generalized dystonia may be due to neurological disorders such as Parkinson’s disease, or may also be a side effect of antipsychotic drugs.

Dystonia may be resolved with anticholinergic drugs or with benzodiazepine drugs.

In some cases, biofeedback training may help.

Injections of botulinum toxin into the affected muscles are effective in treating some types of dystonia.... dystonia

Excessive outward curvature of the spine.

Kyphosis usually affects the spine at the top of the back, resulting in a hump or pronounced rounding of the back.

The condition may be caused by any of a variety of spine disorders.

In some cases, a congenital abnormality may be the cause.

Treatment, which is rarely successful, is of the underlying disorder.

When combined with a curvature of the spine to one side (scoliosis), the condition is known as kyphoscoliosis.... kyphosis

The column of bones and cartilage that extends from the base of the skull to the pelvis, enclosing the spinal cord and supporting the trunk and head. The spine is made up of 33 roughly cylindrical vertebrae. Each pair of adjacent vertebrae is connected by a facet joint, which stabilizes the vertebral column. Between each pair of vertebrae lies a disc-shaped pad of cartilage called an intervertebral disc (see disc, intervertebral). These discs cushion the vertebrae during movement. The vertebrae are bound together by 2 ligaments running the length of the spine and by smaller ligaments between each vertebra. Attached to the vertebrae are several groups of muscles, which control movement of, and help to support, the spine. spine, disorders of Many disorders of the spine cause back pain. Spina bifida is a congenital disorder in which part of the spinal cord is exposed. Sometimes, the spine is abnormally curved (see lordosis, kyphosis, scoliosis). In ankylosing spondylitis, and in some cases of rheumatoid arthritis, spinal joints are affected; osteoarthritis affects the spinal joints of most people over 60. Other disorders affecting the spine are spinal injuries; disc prolapse, and spondylolisthesis.... spine

Inflammation of the vulva and vagina. Vulvovaginitis is often provoked as a result of the infections candidiasis or trichomoniasis. (See also vaginitis; vulvitis.)

walking Movement of the body by lifting the feet alternately and bringing 1 foot into contact with the ground before the other starts to leave it. A person’s gait is determined by body shape, size, and posture. The age at which children first walk varies enormously.

Walking is controlled by nerve signals from the brain’s motor cortex (see cerebrum), basal ganglia, and cerebellum that travel via the spinal cord to the muscles. Abnormal gait may be caused by joint stiffness, muscle weakness (sometimes due to conditions such as poliomyelitis or muscular dystrophy), or skeletal abnormalities (see, for example, talipes; hip, congenital dislocation of; scoliosis; bone tumour; arthritis). Children may develop knock-knee or bowleg; synovitis of the hip and Perthes’ disease are also common. Adolescents may develop a painful limp due to a slipped epiphysis (see femoral epiphysis, slipped) or to fracture or disease of the tibia, fibula or femur.

Abnormal gait may also be the result of neurological disorders such as stroke (commonly resulting in hemiplegia), parkinsonism, peripheral neuritis, multiple sclerosis, various forms of myelitis, and chorea.

Ménière’s disease may cause severe loss of balance and instability.... vulvovaginitis