Classification of Disorders of the Spine

Deformities of the spine:

• Scoliosis
• Kyphosis
• Lordosis

Scoliosis denotes lateral curvature of the spine, there are five types:

Infantile scoliosis – begins in the first year of life as a simple curve, usually convex to the left, without known cause (two groups resolving and progressive).

Idiopathic structural scoliosis – most important type of structural scoliosis; begins in childhood and tends to increase progressively until the cessation of skeletal growth.  Pathology – any part of the thoraco-lumbar spine may be affected.  Treatment includes: turnbuckles (Risser jacket); Milwaukee distraction brace; Dwyer technique; Luque technique.

Secondary structural scoliosis – hemi-vertebra, poliomyelitis, neurofibromatosis.

Compensatory scoliosis – Lumbar scoliosis is seen as a compensatory device when the pelvis is tilted laterally.

Sciatica scoliosis – a temporary deformity produced by the protective action of muscles in certain painful conditions of the spine.  Cause – prolapsed inter-vertebral disc impinging upon a lumbar or sacral nerve.

Kyphosis – term used to define excessive posterior curvature of the spinal column.  The deformity may take the form of a long rounded curve (‘round back’) or there may be a localised sharp posterior angulation (‘hump back’).

Lordosis – is the opposite deformity to kyphosis.  The term denotes excessive anterior curvature of the spinal column (‘hollow back’).

Coccydynia – any painful condition in the region of the coccyx; typically coccydynia develops after an injury – usually a fall on the ‘tail’.  Occasionally a history of injury is lacking.  There is probably a strain of the sacro-coccyygeal joint in other cases the lesion is thought to be simply a contusion of the periosteum over the lower sacrum or the coccyx.  Pain can be worse when sitting, treatment includes: short-wave diathermy.

Congenital abnormalities include:

• Lumbar & sacral variations
• Hemi-vertebra
• Spina bifida