Dr Adriaan Liebenberg My Spine Lumbar | Page 47

My Spine - Lumbar Kyphosis is frequently seen in infective conditions of the spine such as tuber- culosis where the front part of the spine (vertebral body) is destroyed and col- lapses, resulting in the forward curved position. Many neuromuscular conditions, such as cerebral palsy, spina bifida and muscular dystrophies, cause muscle weakness and long abnormal curves (scoliosis). This can be troublesome in the patient’s everyday usage of a wheelchair. Inadequately treated fractures from trauma may result in both kyphosis and scoliosis. Common causes include the group described as “idiopathic” (where the cause is unknown). This is a well-recognised group of young, tall, slim girls developing scoliosis during their teenage years as they go through their growth spurt. In later life, asymmetrical discs and facet joint (the joints between the verte- brae) degeneration may cause segmental instability and degenerative (wear and tear) scoliosis. What are the symptoms? Symptoms vary based on the cause. Congenital (inborn) deformities may be incidentally picked up on a chest X-ray done for other reasons, as these chil- dren often have other associated problems with their kidneys and hearts. The idiopathic group is often noticed at around 10-12 years of age when a posterior thoracic (torso) prominence is noted or hip or shoulder asymmetry. It is usually not painful. There may be breast asymmetry which concerns the young teenage girl. The degenerative group usually presents with both back and leg pain due to narrowing of the spinal canal and nerve root foramina, which causes com- pression of the lumbar nerve roots. These patients may also complain of pro- gressive loss of height and increasingly prominent hip bones. 47