Adolescent kyphosis

　　The exact cause has not been confirmed, and it is generally believed that the disease is caused by a imbalance between the load-bearing capacity of the spine and the load it bears. The lesion occurs in the second ossification center of the vertebral body, that is, the epiphyseal plate on the upper and lower surfaces of the vertebral body. Due to various reasons, the blood supply to the epiphyseal plate decreases, the cartilage plate becomes thin, the compressive strength decreases, and it breaks under excessive load. The nucleus pulposus protrudes into the vertebral body at the破裂 point, forming what is called a Schmorl node. The thoracic spine segment bends backward, causing the pressure on the anterior side of the vertebral body to be greater than that on the posterior side. The necrosis of the anterior epiphysis affects the development of the height of the anterior half of the vertebral body. With the increase of age and the growth of the body, the height of the posterior half of the vertebral body becomes increasingly greater than that of the anterior half, the vertebral body becomes wedge-shaped, and several wedge-shaped vertebral bodies increase the posterior convexity of the thoracic vertebrae, forming kyphosis.

　　Complications of adolescent kyphosis include anterior convexity of the waist, posterior convex畸形 of the thoracic vertebrae. In the late stage, it may be accompanied by spinal osteoarthritis. Adolescent kyphosis seriously affects the growth and development of adolescents, so it should attract the attention of doctors and parents.

　　The early symptoms of this disease include back pain and discomfort, a relatively obvious stiffness, pain located on the midline of the spine, relatively mild, rarely severe pain, discomfort after fatigue, which can be relieved by rest. Subsequently, the posterior convexity of the thoracic spine segment gradually increases, and it becomes difficult to straighten. Examination may reveal a round-arched backward bulge in the back, and passive and active movements cannot change the convex畸形. The anterior convexity of the waist increases compensatorily, but the mobility of the waist is normal. In the late stage of the disease, the symptoms disappear, but the posterior convexity of the thoracic vertebrae remains permanently, and late stage changes in the spinal bone arthritis appear.

　　Youth should pay attention to stretching their chest and back while standing and sitting, maintain good posture, avoid excessive bending or weight-bearing activities, and strengthen their back muscles to effectively prevent hunchback.

　　The typical X-ray manifestations can be divided into 3 stages: in the early stage, the vertebral bodies become wedge-shaped, with the front lower and the back higher, and the upper and lower epiphyses appear speckled changes, the upper and lower margins of the vertebral bodies are rough and uneven, and the intervertebral spaces are slightly narrowed; in the middle stage, the epiphyses appear fragmentation, and the normal shape of the upper and lower angles of the vertebral bodies in front is lost; in the late stage, the epiphyses recover normal density, but the vertebral bodies show permanent wedge-shaped deformation. Schmorl nodules appear in some cases, and an indentation can be seen at the edge of the vertebral body on the X-ray film. The vascular groove existing in front of the vertebral body is also one of the X-ray signs of the disease.

　　The following food therapy formulas have a good effect on the prevention and treatment of adolescent kyphosis:

　　1, Remove the inner membrane of the eggshell, wash and fry it yellow, grind it into fine powder, take 3 grams each time, twice a day, and take it with boiling water.

　　2, Boil chicken bones in soup and take it regularly.

　　3, Take 10 grams of cuttlefish bone, 12 grams of tortoise shell, 6 grams of rhizome of Rubia cordifolia, decoct with brown sugar and take 2-3 times a day.

　　4, Roast chicken bones into crisp powder, take 1-2 grams after meals.

　　5, Roast and grind pork bones into powder, take 6-10 grams after meals.

　　6, Boil pork bones in soup and take it regularly.

　　The treatment of this disease is mainly conservative. Once the condition is diagnosed, the patient should be advised to lie on a hard bed, and try to extend the chest and back when standing and sitting to maintain a good posture. Avoid excessive bending over or weight-bearing activities, and at the same time, strengthen the back muscle exercises, hoping to limit the progression of kyphosis by enhancing the strength of the back muscles. For patients with relatively obvious pain, Chinese herbal medicine for relaxing spasm and analgesia can be used to alleviate symptoms.

　　When the kyphosis of the thoracic vertebra is large and exceeds 50°, it can be fixed with a brace or plaster cast to correct the deformity as much as possible. Close attention should be paid to the complications of passive fixation for correcting deformity, such as soft tissue injury, overcorrection, and scoliosis. The time for fixation with a brace or plaster cast cannot be less than 1 year. Only in a few cases with very severe kyphosis, accompanied by neurological symptoms or severe pain, and for whom symptomatic treatment is ineffective, should surgical treatment be considered. The common method is spinal fusion.