Scheuermann-Mau disease is a progressive deformity of the spinal column that develops during the period of active growth of the body. Without the use of timely adequate therapy, this pathology can lead to very serious consequences.
Description
The occurrence of this problem does not exclude the possibility of some influence of a genetic predisposition, as well as incorrect processes of formation of bone and connective tissue of the spine, an increased level of deposition of calcium salts and other provoking factors. Clinically, a similar disease is manifested by the formation of a kind of hump on the back. In this case, the upper body bends forward, the occurrence of aching pain in the back and fatigue are observed.
Diagnostic measures to establish Scheuermann-Mau disease are usually an integrated approach, but are based on data obtained as a result of instrumental examination. In the process of diagnosis, the actions that are performed by the clinician personally are important. The tactics of treatment largely depends on the degree and severity of the pathological processes, therefore it can be both surgical and conservative, and in any case includes exercises of special therapeutic gymnastics.
The causes of the disease
At present, the exact causes of the formation of Scheuermann-Mau disease are unknown. However, the bulk of medical specialists believe that this problem, which is diagnosed in almost 1% of children today, is the result of certain genetic changes in the body and is most often hereditary.
The main prerequisites for the development of this pathology are:
- Back injuries.
- Lesions of the vertebrae with osteoporosis.
- Disorders in the development of muscles of the lumbar-thoracic or thoracic spine.
- Increased bone growth in the posterior vertebrae.
- Hormonal disorders, as well as pathologies of metabolic processes that develop during the puberty.
- Necrosis of the locking plates in the vertebrae.
- Inadequate physical activity.
- Excessively reduced body weight - at the border with dystrophy.
- The emergence of certain pathologies in the endocrine system.
- Uncomfortable or incorrect back poses for a long period of time.
- Excessive physical overstrain of the chest muscles, as a result of which weakened muscles that are close to the spine are not able to withstand the load, which provokes a stoop in the child.
- Violation of the blood supply processes in the hyaline plates that are located between the vertebrae and vertebral discs.
- Incorrect postures of the child during the educational process - an irrational ratio of the height of the table with the height of the chair.
- Deposition of calcium salts in the ligaments of the spinal column.
Are they enlisted in the army with Scheuermann-Mau disease? About it further.
In addition to the above, among the predisposing factors, the following can be noted:
- excessive addiction to bad habits;
- severe forms of intoxication, as well as uncontrolled use of certain drugs during pregnancy;
- insufficient intake of nutrients and vitamins in the children's body;
- lack of proper and balanced nutrition;
- previously transferred rickets.
This disease is equally found in both girls and boys. Consider the degrees of Scheuermann-Mau disease.
Pathology classification
The overall clinical picture of adolescent kyphosis differs depending on the stage of the disease:
- orthopedic or latent - develops most often in children from eight to fourteen years of age, while only a slight curvature of the spine is detected, pain is absent;
- early - usually occurs between the ages of ten and fifteen years, and is characterized by irregular or constant pain in the thoracic spine;
- late - most often diagnosed in people after twenty years and usually leads to the development of certain complications, including severely limited mobility of the limbs and back.
Juvenile kyphosis has two main varieties, which differ in the form of damage to various parts of the spine:
- the thoracic form, when the lower and middle parts of the spine are involved in pathological processes;
- lumbar-thoracic, in which there is a violation of the upper lumbar and lower thoracic vertebrae.
The main symptoms of the disease
The symptomatology of Scheuermann-Mau disease largely depends on the stage of development of this pathology. For example, with the latent form of the disease, usually the following characteristic clinical manifestations occur:
- discomfort and back pain with prolonged physical exertion;
- an increase in the angle of kyphosis of the chest, and sometimes there is a development of a flat back with pronounced lordosis of the lumbar region;
- slight inhibition of mobility - when bending forward, the patient can not reach the floor with his hands;
- stoop is the most common visual sign that many parents primarily pay attention to.
In the second stage of the progression of Scheuermann-Mau disease, the following symptoms may occur:
- intense irregular or constant pain in the lumbar region;
- an increase in the angle of kyphosis of the thoracic region;
- a change in the sensitivity of the limbs, which is caused, as a rule, by the infringement of some parts of the spinal cord;
- impaired respiratory function;
- changes in the functioning of the urinary organs;
- stool disorders;
- the spread of pain to the area between the shoulder blades;
- heaviness and discomfort in the back;
- shortness of breath with minimal physical exertion.
Symptoms of Scheuermann-Mau disease in adolescents in the third stage are characterized by the presence of the following manifestations:
- postural curvature - the formation of a pronounced hump in the upper back;
- pain syndrome, which is constant, not passing in nature, with a gradual increase in intensity;
- excessive fatigue;
- awkwardness and clumsiness of movements;
- lateral curvature of the spinal column, for example, scoliosis;
- chest pain;
- impaired functioning of the heart;
- loss of sensation in the lower and upper limbs;
- poor spinal mobility;
- lameness;
- sleep disturbance, which occurs as a result of the development of constant pain.
It should also be borne in mind that such a syndrome occurs in about five percent of cases without the development of a pain syndrome.
What is the diagnosis of Scheuermann-Mau disease?
Pathology diagnostics
The disease provokes the occurrence of rather specific symptoms and significantly reduces the quality of human life. Against this background, there may not be problems with the diagnosis of this disease, however, the process of diagnosis is usually an integrated approach.
Initial diagnosis includes the following manipulations by neurologists:
- The study of the medical history and medical history of not only the patient, but also his close relatives.
- Revealing the facts of back injury, or the influence of other predisposing factors that could cause the occurrence of Scheuermann's disease.
- Evaluation of the patient's appearance, as well as mobility and sensitivity of the limbs - both lower and upper.
- Palpation of the spinal column.
- A survey of the patient or his relatives regarding the initial time of occurrence and severity of all clinical manifestations of the pathology, which will indicate to the specialist the severity and form of the disease.
The basis of diagnostic procedures for all age categories of patients is the following instrumental methods:
- X-ray of the spine.
- Electromyography.
- MRI and CT.
Additional diagnostic measures that help confirm the presence of Scheuermann-Mau disease (ICD-10 code M42.0) are laboratory tests:
- General clinical blood and urine tests.
- Biochemical analysis.
- Examination by a cardiologist, neurosurgeon and pulmonologist.
Treatment
The treatment methods for such diseases of the musculoskeletal system are selected, as a rule, by an orthopedic surgeon on the basis of determining the degree of complexity of the pathology and all the data of diagnostic examinations. Treatment must be long and complex.
Among the conservative methods of treatment of Scheuermann-Mau disease, there are:
- Therapeutic massage and manual therapy methods.
- Mud therapy.
- Wearing special corsets.
- Acupuncture.
- Physiotherapeutic procedures.
- Traction of the spinal column.
- Exercise therapy.
In the process of restoring correct posture, special gymnastic exercises in Sheuermann-Mau disease play a special role, the complexes of which are composed exclusively on an individual basis.
Specific therapeutic exercises during the first period of therapy are performed, as a rule, daily, then the exercises should be performed every other day. The whole complex should take about an hour in time. It is also important to remember that if these exercises are performed poorly and irregularly, the positive effect of such exercises is sharply reduced.
Consider the necessary exercises to eliminate Scheuermann-Mau disease in adults:
- Strengthening the muscles of the chest. For these exercises you need to spend 70% of the total time devoted to gymnastics.
- Strengthening the muscles of the buttocks.
- Exercises should be performed to relax the muscles of the back and neck.
- Exercise to relax the pectoral muscles.
- Breathing exercises.
What can not be done in the presence of kyphosis? You can not pump up the pectoral muscles, perform exercises with dumbbells, barbells and weights, the weight of which exceeds 3 kg. It is necessary to reduce the sports load associated with jumping.
Drug treatment of pathology
The treatment of this disease involves taking the following medications:
- chondroprotectors;
- painkillers;
- glucocorticosteroids;
- analgesics;
- mineral and vitamin complexes;
- non-steroidal anti-inflammatory drugs.
With the ineffectiveness of traditional drug therapy, as well as in cases of an increase in the kyphoid angle by more than fifty degrees, the question of surgical intervention becomes. In these cases, the disease is treated with the following methods:
- the establishment of a certain leveling system or a special bridge, which is a metal structure, which is tightened up at certain intervals, which gradually leads to a natural alignment of the spine;
- excision of the affected vertebrae and the introduction of specially designed supporting structures in their place.
The postoperative period of recovery of the body involves the implementation of the same gymnastic therapeutic exercises.
Does disability in Scheuermann-Mau disease give? It is difficult to obtain it precisely on the basis of this diagnosis. The reason for its design is intense pain, the presence of deformation and destruction of bones. Need a specialist consultation on this issue.
Possible consequences and complications
This disease of the spine in the absence of radical therapy in some cases can cause the formation of the following serious consequences:
- intervertebral hernia;
- chronic pain syndrome;
- spondylosis;
- the formation of a hump;
- Schmorl's hernia;
- osteochondrosis;
- deforming spondylarthrosis;
- infringement of the spinal cord;
- myelopathy
- radiculoneuropathy;
- disturbances in the work of all major internal organs.
In adulthood with Scheuermann-Mau disease, early expressed secondary degenerative-dystrophic processes in the spine occur early. This is often accompanied not only by a picture of infringement of the roots of the spinal nerves, but also by chronic progressive myelopathy (dystrophy of the tissue of the spinal cord).
The consequences of the disease, as a rule, lead to complete or partial disability.
Treatment for Scheuermann-Mau disease should be timely.
Disease Prevention and Prognosis
The causes of juvenile kyphosis have not yet been fully established, therefore, preventive measures of this pathology have a general approach. There are no specific methods for preventing the development of this disease. Nevertheless, it is possible to reduce the likelihood of developing this anomaly if you follow some simple rules:
- control the course of pregnancy;
- avoid excessive stress on the spine;
- eat properly and balanced;
- taking medications strictly according to the instructions of a specialist;
- maintaining a healthy and active lifestyle;
- prevention of back injuries;
- timely passage of preventive examinations in medical institutions.
Are they enlisted in the army with Scheuermann-Mau disease?
Suitability for military service
A similar question is quite relevant today, since most draftees have a variety of violations in the formation of the musculoskeletal system. Neither the disease itself, nor its consequences are considered the reason why the young man can be released from military service. After establishing the presence of curvature of the spine, the draftee is usually provided with a delay for appropriate therapy and posture adjustment. In this case, it should be noted that studying the consequences of the disease, the draft committee approaches each draftee individually.
With some advanced stages of the disease, the implementation of generally accepted physical exercises is not allowed. Then they can completely liberate from the army, but this is most often an isolated case, and not a systematic approach.